Charleston Periodonticspa
NPI #1003955659 in Charleston, South Carolina
Provider Information
- NPI Number
- 1003955659
- Entity Type
- Organization
- Organization Name
- Charleston Periodonticspa
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Feb 6, 2007
- Last Updated
- May 2, 2011
Practice Location
- Address
- 1051 GARDNER RD
- Address 2
- SUITE A
- City
- Charleston
- State
- South Carolina
- ZIP Code
- 29407-5747
- Phone
- (843) 766-7131
Authorized Official
- Name
- DR. JEFFREY J LARO, DMD MHS
- Title
- PERIODONTIST
- Phone
- (843) 766-7131
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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