Organization
WENTWORTH STREET DENTAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGERS CONYERS REEVES D.M.D. (C.E.O.)
(843) 577-2898
Entity
Organization
Contact information
Practice address
159 WENTWORTH ST, CHARLESTON, SC 29401-6715
(843) 577-2898
(843) 577-4464
Mailing address
159 WENTWORTH ST, CHARLESTON, SC 29401-6715
(843) 577-2898
(843) 577-4464
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1547
SC
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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