# ASHBY PARK PEDIATRIC DENTISTRY RIVER FALLS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASHBY PARK PEDIATRIC DENTISTRY, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093081648
- **Legal business name:** ASHBY PARK PEDIATRIC DENTISTRY, LLC
- **Authorized official:** DR. JENNIFER LYNN GARVEY DMD (PRESIDENT)
- **Authorized official phone:** (864) 433-6888

## Contact information

- **Practice address:** 505 SQUIRES PT, DUNCAN, SC 29334-8867
- **Practice address phone:** (864) 433-6888
- **Practice address fax:** (864) 433-6889
- **Mailing address:** 505 SQUIRES PT, DUNCAN, SC 29334-8867
- **Mailing address phone:** (864) 433-6888
- **Mailing address fax:** (864) 433-6889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3638 | SC | Yes |

## Other

- **Enumeration date:** 03/28/2012
- **Last updated:** 08/20/2012