OrganizationActive
Medical University of South Carolina
NPI 1639593254 · Oral and Maxillofacial Pathology Dentistry · Charleston, SC
Provider details
- NPI number
- 1639593254
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Theresa Gonzales, Director(843) 792-4496
Specialties & taxonomies
Dental Providers
Practice location
173 Ashley Ave
Charleston, SC 29425-8908
Phone: (843) 792-4496
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 10076
Van Nuys, CA 91410-0076
Other names (DBA / former)
- Doing business as
- Theresa Sullivan Gonzales DMD Ms Mss
Registry dates
- Enumerated
- 2014-02-18
- Last updated
- 2014-02-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.