Provider Demographics
NPI:1902814304
Name:UHL, JOHN MARSHALL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARSHALL
Last Name:UHL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WESTLAKE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5924
Mailing Address - Country:US
Mailing Address - Phone:803-788-4243
Mailing Address - Fax:
Practice Address - Street 1:4650 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4016
Practice Address - Country:US
Practice Address - Phone:803-896-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice