Provider Demographics
NPI:1487133054
Name:TGD-HANAHAN LLC
Entity type:Organization
Organization Name:TGD-HANAHAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,MBA
Authorized Official - Phone:843-554-4545
Mailing Address - Street 1:1224 YEAMANS HALL RD
Mailing Address - Street 2:
Mailing Address - City:HANAHAN
Mailing Address - State:SC
Mailing Address - Zip Code:29410-2750
Mailing Address - Country:US
Mailing Address - Phone:843-554-4545
Mailing Address - Fax:
Practice Address - Street 1:1224 YEAMANS HALL RD
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-2750
Practice Address - Country:US
Practice Address - Phone:843-554-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC70271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty