# FAMILY DENTAL CENTER, LLC

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

## Provider details

- **NPI number:** 1134409345
- **Authorized official:** PETER STATHAKIS (CFO)
- **Authorized official phone:** (312) 274-0308

## Contact information

- **Practice address:** 6134 WHITE HORSE RD, STE. C, GREENVILLE, SC 29611-3837
- **Practice address phone:** (312) 274-0308
- **Mailing address:** 6134 WHITE HORSE RD, STE. C, GREENVILLE, SC 29611-3837
- **Mailing address phone:** (312) 274-0308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2011
- **Last updated:** 08/18/2011