Provider Demographics
NPI:1548829088
Name:HIGH POINT FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:HIGH POINT FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOWER
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-621-1104
Mailing Address - Street 1:23 GREETERS LN
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7027
Mailing Address - Country:US
Mailing Address - Phone:843-621-1104
Mailing Address - Fax:
Practice Address - Street 1:10911 N JACOB SMART BLVD STE C
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-2729
Practice Address - Country:US
Practice Address - Phone:843-898-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-09
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental