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Organization

114 KERSHAW DENTAL, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW COOK (OWNER)
(803) 479-1795
Entity
Organization

Contact information

Practice address
114 E HILTON ST, KERSHAW, SC 29067-1318
(803) 475-6052
Mailing address
PO BOX 330, EDGEFIELD, SC 29824-0330

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/27/2015
Last updated
05/27/2015
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