Organization
PHILIP PRICKETT/ MT. PLEASANT ORAL FACIAL & IMPLANT
Active
Other names
Low Country Oral Facial & Implant
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP M PRICKETT D.M.D. (PHYSICIAN)
(843) 971-0041
Entity
Organization
Contact information
Practice address
1311 CHUCK DAWLEY BLVD STE 101, MT PLEASANT, SC 29464-7303
(843) 971-0041
(843) 971-0043
Mailing address
7465A NORTHSIDE DR, CHARLESTON, SC 29420-4209
(843) 797-7600
(843) 797-7905
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1481
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3132
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9913
—
SC
Enumeration date
01/11/2007
Last updated
06/26/2008
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