Southlake Family Dentistry LLC
NPI #1487670667 in Fort Mill, South Carolina
Provider Information
- NPI Number
- 1487670667
- Entity Type
- Organization
- Organization Name
- Southlake Family Dentistry LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jul 14, 2006
- Last Updated
- Jul 16, 2007
Practice Location
- Address
- 1741 GOLD HILL RD
- Address 2
- SUITE 2010
- City
- Fort Mill
- State
- South Carolina
- ZIP Code
- 29708-8202
- Phone
- (803) 548-3342
Authorized Official
- Name
- DR. GARY C KIMSEY, D.M.D.,F.A.G.D.
- Title
- PRESIDENT
- Phone
- (803) 548-3342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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