# ASHBY PARK PEDIATRIC DENTISTRY EASLEY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASHBY PARK PEDIATRIC DENTISTRY, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417309451
- **Legal business name:** ASHBY PARK PEDIATRIC DENTISTRY, LLC
- **Authorized official:** JENNIFER GARVEY (PARTNER/OWNER)
- **Authorized official phone:** (864) 234-3424

## Contact information

- **Practice address:** 708 NORTH A STREET, EASLEY, SC 29640
- **Practice address phone:** (864) 605-7741
- **Mailing address:** 708 NORTH A STREET, EASLEY, SC 29640
- **Mailing address phone:** (864) 605-7741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3638 | SC | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 3638 | SC | — |

## Other

- **Enumeration date:** 07/01/2016
- **Last updated:** 07/01/2016