Individual
DR. EDNA KLATT DEPAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
701 LEADER LN, MT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Mailing address
701 LEADER LN, MT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2529
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2529
SC DENTAL LICENCE
SC
01
—
488297
UNITED CONCORDIA INS CO
SC
05
—
992529
—
SC
Enumeration date
06/22/2005
Last updated
08/08/2013
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