Organization
WHITE KNOLL DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA RAY BACKMAN DMD (DENTIST)
(803) 359-3245
Entity
Organization
Contact information
Practice address
5545 PLATT SPRINGS RD, LEXINGTON, SC 29073
(803) 359-3245
Mailing address
341 LONGWOOD DR, LEXINGTON, SC 29073-8537
(803) 359-3245
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4290
SC
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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