Individual
JOHN W CORDRAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
753 ST ANDREWS BLVD, CHARLESTON, SC 29407
(843) 571-6371
Mailing address
753 ST ANDREWS BLVD, CHARLESTON, SC 29407
(843) 571-6371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2167
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423057
—
SC
Enumeration date
11/14/2006
Last updated
07/08/2007
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