Organization
TRIDENT GENERAL DENTISTRY, DOUGLAS S RAWLS, DM
Active
Parent organization
TRIDENT GENERAL DENTISTRY, DOUGLAS S RAWLS, DMD, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIDENT GENERAL DENTISTRY, DOUGLAS S RAWLS, DMD, LLC
Authorized official
DR. DOUGLAS S RAWLS DMD (OWNER (SINGLE MEMBER OF LLC))
(843) 552-2580
Entity
Organization
Contact information
Practice address
6335 DORCHESTER ROAD, NORTH CARLESTON, SC 29418
(843) 552-2580
(843) 552-2596
Mailing address
6335 DORCHESTER ROAD, NORTH CARLESTON, SC 29418
(843) 552-2580
(843) 552-2596
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1823
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
W17307SC1
—
SC
Enumeration date
07/25/2011
Last updated
07/25/2011
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