Lyndon Craig Alford, D.M.D.

Individual provider Active NPI General Practice Dentistry · North Charleston, SC

NPI 1841370533 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1841370533
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3097 (SC)
Practice address
8730 Northpark Blvd
Building 1; Suite a
North Charleston, SC 29406-9265
Phone
(843) 572-1033
Fax
(843) 572-0211
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

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
3097SCMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3097 SC Yes

Addresses

Primary practice location

8730 Northpark Blvd
Building 1; Suite a
North Charleston, SC 29406-9265

Mailing address

8730 Northpark Blvd
Building 1; Suite a
North Charleston, SC 29406-9265
Phone (843) 572-1033

Other identifiers

IdentifierTypeStateIssuer
Z30976MedicaidSC

Other providers in North Charleston, SC

All providers in North Charleston, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.