Individual
DR. RENATA SERRICCHIO LEITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, DDS
Contact information
Practice address
29 BEE STREET, CHARLESTON, SC 29425-0001
(843) 792-3908
Mailing address
PO BOX 12595, CHARLESTON, SC 29422-2595
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
29
SC
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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