Individual
DR. JACK MESSENGER CONDREY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5306 PARKSHIRE WAY, CHARLESTON, SC 29418-2000
(843) 552-1600
(843) 552-0049
Mailing address
5306 PARKSHIRE WAY, CHARLESTON, SC 29418-2000
(843) 552-1600
(843) 552-0049
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2785
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
992785
—
SC
Enumeration date
07/19/2006
Last updated
07/09/2007
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