Individual
DR. PONGSAKORN POOVARODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSC, PHD
Contact information
Practice address
173 ASHLEY AVE # MSC507, CHARLESTON, SC 29425-8908
(843) 792-3811
Mailing address
3489 BILLINGS ST, MOUNT PLEASANT, SC 29466-6882
(854) 858-2195
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
60
SC
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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