# MIDLANDS PEDIATRIC DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841667037
- **Authorized official:** DR. ROBERT LAFORREST SHOUN DMD (DENTIST/OWNER)
- **Authorized official phone:** (803) 348-8976

## Contact information

- **Practice address:** 253 CEDARCREST DR, LEXINGTON, SC 29072-3812
- **Practice address phone:** (803) 951-7337
- **Mailing address:** 221 SPRINGS CT, WEST COLUMBIA, SC 29170-2474
- **Mailing address phone:** (803) 951-7337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3801 | SC | Yes |

## Other

- **Enumeration date:** 08/24/2015
- **Last updated:** 08/24/2015