Provider Demographics
NPI:1316727928
Name:TDSP-NC ATLANTIC ENDODONTICS, LLC
Entity type:Organization
Organization Name:TDSP-NC ATLANTIC ENDODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MBA
Authorized Official - Phone:843-408-9151
Mailing Address - Street 1:6335 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-5103
Mailing Address - Country:US
Mailing Address - Phone:843-408-9151
Mailing Address - Fax:
Practice Address - Street 1:6335B DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-5103
Practice Address - Country:US
Practice Address - Phone:843-552-2580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIDENT DENTAL PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty