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Organization
GOOSE CREEK DENTAL CARE LLC
Active
Organization
GOOSE CREEK DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON THOMAS BARGANIER D.M.D (OWNER)
(843) 553-5235
Entity
Organization
Contact information
Practice address
100 BERKELEY SQUARE LN, GOOSE CREEK, SC 29445-2958
(843) 553-5235
Mailing address
PO BOX 1120, GOOSE CREEK, SC 29445-1120
(843) 553-5235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2059735
UNITIED CONCORDIA
SC
05
—
ZX4473
—
SC
Enumeration date
04/05/2011
Last updated
04/05/2011
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