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Organization

DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.

Active
Other names
Ashby Park Restorative and Cosmetic Dentistry PA
Organization subpart
No

Provider details

NPI number
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization

Contact information

Practice address
303 ASHBY PARK LN, GREENVILLE, SC 29607-6903
(864) 987-5578
(864) 987-0351
Mailing address
303 ASHBY PARK LN, GREENVILLE, SC 29607-6903
(864) 987-5578
(864) 987-0351

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3791
SC

Other

Enumeration date
03/31/2015
Last updated
05/07/2018
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