Dental Professional of Sc
NPI #1548685191 in Aiken, South Carolina
Provider Information
- NPI Number
- 1548685191
- Entity Type
- Organization
- Organization Name
- Dental Professional of Sc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DENTAL PROFESSIONAL OF SC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 19, 2014
- Last Updated
- Feb 19, 2014
Practice Location
- Address
- 1055 PINE LOG RD
- City
- Aiken
- State
- South Carolina
- ZIP Code
- 29803-7396
- Phone
- (803) 761-7924
Authorized Official
- Name
- JEAN CORNELL
- Title
- INSURANCE/CREDENTIALING
- Phone
- (217) 540-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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