Organization
MATHIS FERRY DENTAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA KLATT DEPAUL DMD (OWNER)
(843) 345-2307
Entity
Organization
Contact information
Practice address
701 LEADER LN, MOUNT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Mailing address
701 LEADER LN, MOUNT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
02529
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
488297
UNITED CONCORDIA
SC
05
—
ZA9806
—
SC
Enumeration date
03/21/2007
Last updated
08/08/2013
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