NPI 1710102405 · live from the CMS NPI Registry
Lavonne Kelly Fore, DMD, MSD
Dentist, Orthodontics and Dentofacial Orthopedics in Charleston, SC. National Provider Identifier 1710102405, active.
NPI record
| NPI | 1710102405 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 915 Folly Rd Ste T, Charleston, SC 29412 |
| Practice phone | 843-642-8100 |
| Enumerated | April 16, 2007 |
| Last updated | April 9, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 9106-981 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.