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Organization
PALMETTO HEALTH
Active
Organization
PALMETTO HEALTH
Active
Parent organization
PALMETTO HEALTH
Other names
Palmetto Health Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO HEALTH
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICES FINAN)
(803) 296-7301
Entity
Organization
Contact information
Practice address
10 RICHLAND MEDICAL PARK DR, SUITE A, COLUMBIA, SC 29203-6864
(803) 434-6567
(803) 434-6299
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7303
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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