Organization
CHAPIN PEDIATRIC DENTISTRY LLC
Active
Other names
Prime Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY BOURGOYNE (OFFICE MANAGER)
(843) 536-9888
Entity
Organization
Contact information
Practice address
192 BROOMSTRAW RD., CHAPIN, SC 29036
(843) 536-9888
Mailing address
2420 HOFFMEYER RD UNIT A, FLORENCE, SC 29501-7426
(843) 536-9888
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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