Organization
IMMEDIATE DENTAL GROUP LLC - NORTH CHARLESTON
Active
Other names
Immediate Dental Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY TODD DAUGHERTY (BUSINESS MANAGER)
(843) 480-9500
Entity
Organization
Contact information
Practice address
5900 RIVERS AVE, UNIT X, NORTH CHARLESTON, SC 29406-6054
(843) 480-5900
(843) 480-9502
Mailing address
5900 RIVERS AVE, UNIT X, NORTH CHARLESTON, SC 29406-6054
(843) 480-5900
(843) 480-9502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/20/2012
Last updated
01/22/2013
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