Provider Demographics
NPI:1912791856
Name:UPTOWN FAMILY DENTAL
Entity type:Organization
Organization Name:UPTOWN FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-419-8880
Mailing Address - Street 1:106 GOSLING WAY STE G
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-8917
Mailing Address - Country:US
Mailing Address - Phone:843-419-8880
Mailing Address - Fax:843-419-8899
Practice Address - Street 1:106 GOSLING WAY STE G
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-8917
Practice Address - Country:US
Practice Address - Phone:843-419-8880
Practice Address - Fax:843-419-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty