Organization
CANE BAY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER OLIVER (OWNER)
(843) 352-4454
Entity
Organization
Contact information
Practice address
1724 STATE RD UNIT 4D, SUMMERVILLE, SC 29486-2842
(843) 352-4454
(843) 352-4875
Mailing address
1724 STATE RD UNIT 4D, SUMMERVILLE, SC 29486-2842
(843) 352-4454
(843) 352-4875
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8137
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295045771
STATE
SC
01
—
1366858870
STATE
SC
01
—
1396110078
STATE
SC
01
—
1710969845
STATE
SC
01
—
1982056966
STATE
SC
Enumeration date
07/12/2016
Last updated
07/12/2016
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