Organization
CHILDREN AND ADULT DENTAL LLC
Active
Other names
Broad River Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA PATTERSON (PRACTICE ADMINISTRATOR)
(803) 600-7211
Entity
Organization
Contact information
Practice address
7210K BROAD RIVER RD, IRMO, SC 29063-7973
(803) 407-2220
Mailing address
7210K BROAD RIVER RD, IRMO, SC 29063-7973
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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