Individual
DR. JENNIE O REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9565 HIGHWAY 78, UNIT 600B, LADSON, SC 29456-4118
(843) 412-4036
Mailing address
9565 HIGHWAY 78, UNIT 600B, LADSON, SC 29456-4118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8265
SC
Other
Enumeration date
08/15/2013
Last updated
09/20/2013
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