Organization
CDA DENTAL PA
Active
Other names
Lyman Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER DEREK AYERS DMD (PRESIDENT)
(843) 406-3678
Entity
Organization
Contact information
Practice address
301 SPARTANBURG RD, LYMAN, SC 29365-1746
(864) 439-1240
(864) 439-1241
Mailing address
301 SPARTANBURG RD, LYMAN, SC 29365-1746
(864) 439-1240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6942
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX6942
—
SC
Enumeration date
04/23/2014
Last updated
04/23/2014
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