# PALMETTO HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PALMETTO HEALTH
- **Other names:** Palmetto Health Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104370188
- **Legal business name:** PALMETTO HEALTH
- **Authorized official:** DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICES FINAN)
- **Authorized official phone:** (803) 296-7301

## Contact information

- **Practice address:** 10 RICHLAND MEDICAL PARK DR, SUITE A, COLUMBIA, SC 29203-6864
- **Practice address phone:** (803) 434-6567
- **Practice address fax:** (803) 434-6299
- **Mailing address:** PO BOX 402145, ATLANTA, GA 30384-2145
- **Mailing address phone:** (803) 296-7303
- **Mailing address fax:** (803) 296-7330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2016
- **Last updated:** 08/08/2016