Individual
CHARLES JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1720 OLD TROLLEY RD, SUMMERVILLE, SC 29485-8278
(864) 640-6757
Mailing address
1629 TIMOTHY ST, CHARLESTON, SC 29407-7902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9899
SC
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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