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Organization
MUSC COLLEGE OF DENTAL MEDICINE
Active
Organization
MUSC COLLEGE OF DENTAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BALLENTINE (ASSOCIATE ACADEMIC PROG DIRECTOR)
(843) 792-2441
Entity
Organization
Contact information
Practice address
29 BEE ST, CHARLESTON, SC 29425-0001
(843) 876-7645
Mailing address
PO BOX 737811, DALLAS, TX 75373-7811
(843) 876-7645
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
SC-3198
SC
Other
Enumeration date
05/15/2007
Last updated
11/20/2025
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