David Allan Bodie, DMD

Individual provider Active NPI General Practice Dentistry · Mount Pleasant, SC

NPI 1033404124 · NPPES record last updated Jun 16, 2011

Key facts

NPI
1033404124
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7009 (SC)
Practice address
929 Bowman Rd Ste 100
Mount Pleasant, SC 29464-3237
Phone
(843) 971-0661
Fax
(843) 971-5219
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7009SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossland Dental Associates, Inc. General Practice Past Accepting new patients
Crossland and Bodie Dental Associates LLC General Practice Past
since Jun 22, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7009 SC Yes

Addresses

Primary practice location

929 Bowman Rd Ste 100
Mount Pleasant, SC 29464-3237

Mailing address

929 Bowman Rd Ste 100
Mount Pleasant, SC 29464-3237
Phone (843) 971-0661

Other providers in Mount Pleasant, SC

All providers in Mount Pleasant, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.