Provider Demographics
NPI:1235666843
Name:WARE, MILES CHRISTIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MILES
Middle Name:CHRISTIAN
Last Name:WARE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TIDAL REEF CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7771
Mailing Address - Country:US
Mailing Address - Phone:864-650-6266
Mailing Address - Fax:
Practice Address - Street 1:2121 N MAIN ST UNIT 101
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-8545
Practice Address - Country:US
Practice Address - Phone:843-853-5859
Practice Address - Fax:843-853-5961
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10306204E00000X
SC102551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery