Organization
HEAD DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHEN DOUGLAS HEAD DMD (MANAGER)
(803) 673-4788
Entity
Organization
Contact information
Practice address
1483 TOBIAS GADSON BLVD, SUITE 105, CHARLESTON, SC 29407-8702
(843) 556-3838
(843) 556-4325
Mailing address
1483 TOBIAS GADSON BLVD, SUITE 105, CHARLESTON, SC 29407-8702
(843) 556-3838
(843) 556-4325
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8070
SC
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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