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Organization
GD SC COLUMBIA, LLC
Active
Organization
GD SC COLUMBIA, LLC
Active
Other names
Southern Smiles Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
160 SUMMIT CENTRE DR, COLUMBIA, SC 29229-7612
(803) 699-7224
Mailing address
160 SUMMIT CENTRE DR, COLUMBIA, SC 29229-7612
(803) 699-7224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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