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Organization

CHARLESTON IMPLANT & SEDATION DENTISTRY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RYAN N. GILREATH (OWNER)
(843) 810-0109
Entity
Organization

Contact information

Practice address
124 S GOOSE CREEK BLVD STE D, GOOSE CREEK, SC 29445-3136
(843) 501-1965
Mailing address
122A S GOOSE CREEK BLVD, GOOSE CREEK, SC 29445-3136

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
1223G0001X
General Practice Dentistry
Primary
1223P0300X
Periodontics
1223P0700X
Prosthodontics
1223S0112X
Oral and Maxillofacial Surgery (Dentist)

Other

Enumeration date
05/02/2022
Last updated
05/02/2022
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