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Organization
FOUNTAIN INN DENTAL, LLC
Active
Organization
FOUNTAIN INN DENTAL, LLC
Active
Other names
Fountain Inn Dental
Organization subpart
No
Provider details
NPI number
Authorized official
VIKAS R. JAIN DMD (OWNER)
(706) 877-4110
Entity
Organization
Contact information
Practice address
1125 N MAIN ST, FOUNTAIN INN, SC 29644-1322
(864) 409-7733
Mailing address
1125 N MAIN ST, FOUNTAIN INN, SC 29644-1322
(864) 409-7733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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