Mid-Carolina Dental Care, INC

NPI #1073050639 in Prosperity, South Carolina

Provider Information

NPI Number: 1073050639
Entity Type: Organization
Organization Name: Mid-Carolina Dental Care, INC
Primary Specialty: Dentist
Enumeration Date: Jan 20, 2017
Last Updated: Jan 20, 2017

Practice Location

Address: 316 N WHEELER AVE
City: Prosperity
State: South Carolina
ZIP Code: 29127
Phone: (803) 364-2726

Authorized Official

Name: DR. JOHN CAMPBELL LAKE JR., D.M.D.
Title: GENERAL DENTIST
Phone: (803) 276-2090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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