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Organization
LOTUS DENTAL ASSOCIATES LLC
Active
Organization
LOTUS DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NHUNG PHAN DMD (OWNER)
(803) 548-8858
Entity
Organization
Contact information
Practice address
1365 BROADCLOTH ST STE 204, FORT MILL, SC 29715-4507
(803) 548-8858
(803) 548-8860
Mailing address
1365 BROADCLOTH ST STE 204, FORT MILL, SC 29715-4507
(803) 548-8858
(803) 548-8860
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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