Dental Professionals of South Carolina, P.c.
NPI #1730455965 in Blythewood, South Carolina
Provider Information
- NPI Number
- 1730455965
- Entity Type
- Organization
- Organization Name
- Dental Professionals of South Carolina, P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 2, 2012
- Last Updated
- Apr 2, 2012
Practice Location
- Address
- 213 MAIN STREET
- City
- Blythewood
- State
- South Carolina
- ZIP Code
- 29016-0589
- Phone
- (803) 754-9545
Authorized Official
- Name
- KIM WILSON
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-5170
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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