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Organization
EDGAR H PEACOCK, JR, DDS, PA
Active
Organization
EDGAR H PEACOCK, JR, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR HAROLD PEACOCK JR. D. D. S (PRESIDENT)
(803) 256-9268
Entity
Organization
Contact information
Practice address
2750 LAUREL ST, SUITE 202, COLUMBIA, SC 29204-2038
(803) 256-9268
(803) 256-0084
Mailing address
2750 LAUREL ST, SUITE 202, COLUMBIA, SC 29204-2038
(803) 256-9268
(803) 256-0084
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1545/OS161
SC
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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