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Organization

SFD KIDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANGELA BAZZLE (OPERATIONS MANAGER)
(843) 871-0842
Entity
Organization

Contact information

Practice address
108 PARISH FARMS DRIVE, SUMMERVILLE, SC 29486
(843) 871-0842
Mailing address
1971 N MAIN ST, SUMMERVILLE, SC 29486-7820
(843) 871-0842

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8227
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX8227
SC
Enumeration date
02/13/2017
Last updated
02/13/2017
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