Organization
FAMILY DENTAL HEALTH OF HALTON ROAD, LLC
Active
Parent organization
FDH HOLDINGS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FDH HOLDINGS, LLC
Authorized official
BETH ILLSLEY (DIRECTOR OF INSURANCE)
(864) 282-1935
Entity
Organization
Contact information
Practice address
155 HALTON VILLAGE CIR STE A, GREENVILLE, SC 29607-6825
(864) 289-9752
(864) 751-6387
Mailing address
110 VILLA RD, GREENVILLE, SC 29615-3010
(864) 282-1935
(864) 751-6387
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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