Provider Demographics
NPI:1063579399
Name:LOWCOUNTRY DENTISTRY INC.
Entity type:Organization
Organization Name:LOWCOUNTRY DENTISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HAFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-821-2500
Mailing Address - Street 1:402 OLD TROLLEY RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-5608
Mailing Address - Country:US
Mailing Address - Phone:843-821-2500
Mailing Address - Fax:843-821-2092
Practice Address - Street 1:402 OLD TROLLEY RD
Practice Address - Street 2:SUITE 109
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5608
Practice Address - Country:US
Practice Address - Phone:843-821-2500
Practice Address - Fax:843-821-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3604122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty