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NPI 1043409063

OrganizationActive

Charleston Oral and Facial Surgery, Inc.

NPI 1043409063 · Oral and Maxillofacial Surgery (Dentist) · Ladson, SC

Provider details

NPI number: 1043409063
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Parent organization: Charleston Oral and Facial Surgery
Authorized official: Jackie Holloway, Director of Rcm
License: 4006 (SC)

Practice location

3700 Ingleside Blvd

Ladson, SC 29456-4141

Phone: (843) 762-9028

More SC providers

Mailing address

3700 Ingleside Blvd Ste 1

Ladson, SC 29456-4141

Registry dates

Enumerated: 2007-10-16
Last updated: 2025-11-24

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Charleston Oral and Facial Surgery, Inc. — NPI 1043409063, Ladson, SC | NPI Central