Organization
PEELE DENTAL
Active
Other names
Cooper Cosmetic and Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PEELE DDS (DENTIST, OWNER)
(919) 360-6882
Entity
Organization
Contact information
Practice address
4830 CHATEAU AVE, NORTH CHARLESTON, SC 29405-4806
(919) 360-6882
Mailing address
1110 NORTH BLVD, NORTH CHARLESTON, SC 29405-4315
(919) 360-6882
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174917629
PEELE NPI 1
SC
Enumeration date
08/28/2019
Last updated
08/28/2019
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