Organization
CAROLINA AVENUE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA B PIPKIN DMD (PRESIDENT)
(843) 899-5911
Entity
Organization
Contact information
Practice address
214 CAROLINA AVENUE, MONCKS CORNER, SC 29461
(843) 899-5911
(843) 899-5961
Mailing address
214 CAROLINA AVENUE, MONCKS CORNER, SC 29461
(843) 899-5911
(843) 899-5968
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC3281
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
567546
UNITED CONCORDIA
SC
05
—
Z32812
—
SC
Enumeration date
09/21/2006
Last updated
08/22/2020
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