# SOUTHERN PEDIATRIC DENTISTRY P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003295031
- **Authorized official:** KATHERINE BRAY BRYANT D.M.D. (PEDIATRIC DENTIST)
- **Authorized official phone:** (864) 844-9393

## Contact information

- **Practice address:** 1515 N FANT ST, ANDERSON, SC 29621-4707
- **Practice address phone:** (864) 844-9393
- **Practice address fax:** (864) 844-9395
- **Mailing address:** 1515 N FANT ST, ANDERSON, SC 29621-4707
- **Mailing address phone:** (864) 844-9393
- **Mailing address fax:** (864) 844-9395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 4046 | SC | Yes |

## Other

- **Enumeration date:** 05/22/2015
- **Last updated:** 05/22/2015