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Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Organization
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
Active
Other names
PH Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LAWRENCE (DIRECTOR, PROVIDER ENROLLMENT)
(864) 522-8611
Entity
Organization
Contact information
Practice address
10 RICHLAND MEDICAL PARK DR STE A, COLUMBIA, SC 29203-6892
(803) 434-6565
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 293-7330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
SC
Other
Enumeration date
06/28/2018
Last updated
02/22/2022
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