Organization
CHARLESTON PERIODONTICSPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY J LARO DMD MHS (PERIODONTIST)
(843) 766-7131
Entity
Organization
Contact information
Practice address
1051 GARDNER RD, SUITE A, CHARLESTON, SC 29407-5747
(843) 766-7131
(843) 766-1839
Mailing address
1051 GARDNER RD, SUITE A, CHARLESTON, SC 29407-5747
(843) 766-7131
(843) 766-1839
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
02/06/2007
Last updated
05/02/2011
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