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Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Other names
Crowfield Dental
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH FISH (CREDENTIALING MANAGER)
(217) 540-5699
Entity
Organization
Contact information
Practice address
102 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8009
(843) 377-0509
Mailing address
102 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8009
(843) 377-0509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1393195
UNITED CONCORDIA
SC
05
—
ZA9634
—
SC
05
—
ZX3808
—
SC
Enumeration date
04/04/2007
Last updated
06/21/2023
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