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Organization
FT MILL DENTISTRY LLC
Active
Organization
FT MILL DENTISTRY LLC
Active
Other names
Fort Mill Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY DEAN (OFFICE ADMINISTRATOR)
(803) 547-7508
Entity
Organization
Contact information
Practice address
133 CLEBOURNE ST, FORT MILL, SC 29715-1742
(803) 547-7508
(803) 547-1070
Mailing address
PO BOX 489, FORT MILL, SC 29716-0489
(803) 547-7508
(803) 547-1070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4178
SOUTH CAROLINA BOARD OF DENTISTRY
SC
01
—
4481
SOUTH CAROLINA BOARD OF DENTISTRY
SC
Enumeration date
09/15/2021
Last updated
09/15/2021
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