Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medical University of South Carolina

Organization Oral and Maxillofacial Pathology Dentistry · NPI 1639593254

Medical University of South Carolina is an Oral and Maxillofacial Pathology Dentistry in Charleston, South Carolina. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

173 Ashley Ave
Charleston, SC 29425-8908
Phone: (843) 792-4496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X

Record details

NPI number1639593254
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Gonzales — Director · (843) 792-4496
Other names Theresa Sullivan Gonzales Dmd Ms Mss
NPI enumeratedFebruary 18, 2014
Last updated in NPPESFebruary 18, 2014
Mailing addressPo Box 10076, Van Nuys, CA 91410-0076

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