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Organization
SFD CARNES LLC
Active
Organization
SFD CARNES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA M BAZZLE (OPERATIONS MANAGER)
(843) 871-0842
Entity
Organization
Contact information
Practice address
110 PARISH FARMS DR, SUMMERVILLE, SC 29486-0409
(843) 300-1635
(843) 300-1639
Mailing address
1971 N MAIN ST, SUMMERVILLE, SC 29486-7820
(843) 871-0842
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3352
SC
1223G0001X
General Practice Dentistry
Primary
8091
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z33526
—
SC
05
—
ZX8091
—
SC
Enumeration date
11/16/2016
Last updated
02/08/2017
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