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Organization

PALMETTO HEALTH

Active
Parent organization
PALMETTO HEALTH
Other names
Palmetto Health Dental Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
PALMETTO HEALTH
Authorized official
DARRELL C COVEN (DIRECTOR, AMBULATORY SERVICES FINAN)
(803) 296-7301
Entity
Organization

Contact information

Practice address
10 RICHLAND MEDICAL PARK DR, SUITE A, COLUMBIA, SC 29203-6864
(803) 434-6567
(803) 434-6299
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7303
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
08/08/2016
Last updated
08/08/2016
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