Provider Demographics
NPI:1811048135
Name:CALCOTE, ROBERT DUDLEY (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DUDLEY
Last Name:CALCOTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:163 RUTLEDGE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5823
Mailing Address - Country:US
Mailing Address - Phone:843-577-7140
Mailing Address - Fax:843-577-7152
Practice Address - Street 1:163 RUTLEDGE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5823
Practice Address - Country:US
Practice Address - Phone:843-577-7140
Practice Address - Fax:843-577-7152
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics