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Organization
CATAWBA RIVER DENTISTRY, LLC
Active
Organization
CATAWBA RIVER DENTISTRY, LLC
Active
Other names
Dr Logan Ebersold DMD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE R MONTUORI (OFFICE MANAGER)
(803) 396-5888
Entity
Organization
Contact information
Practice address
200 N DOBYS BRIDGE RD STE 108, FORT MILL, SC 29715-2084
(803) 396-5888
(803) 396-5893
Mailing address
200 N DOBYS BRIDGE RD STE 108, FORT MILL, SC 29715-2084
(803) 396-5888
(803) 396-5893
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770100505
GENERAL DENTIST
—
Enumeration date
10/18/2023
Last updated
10/18/2023
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