Provider Demographics
NPI:1164503629
Name:LENOIR, ROSEMARY LABONGE (RDH)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:LABONGE
Last Name:LENOIR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 BRIANNA LANE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412
Mailing Address - Country:US
Mailing Address - Phone:843-795-8942
Mailing Address - Fax:
Practice Address - Street 1:113 WAPPOO CREEK DR
Practice Address - Street 2:SUITE 5
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2136
Practice Address - Country:US
Practice Address - Phone:843-762-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1597124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist