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Organization
DUTCH FORK FAMILY DENTISTRY, PA
Active
Organization
DUTCH FORK FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERRY BENENHALEY RAUCH DDS (PRESIDENT)
(803) 749-3333
Entity
Organization
Contact information
Practice address
7436 BROAD RIVER RD STE 111, IRMO, SC 29063-7601
(803) 749-3333
(803) 749-3335
Mailing address
7436 BROAD RIVER RD STE 111, IRMO, SC 29063-7601
(803) 749-3333
(803) 749-3335
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4654
SC
Other
Enumeration date
02/19/2013
Last updated
02/19/2013
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