Organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Other names
Carnes Crossroads Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
501 CARNES CROSSING BLVD STE A, SUMMERVILLE, SC 29486-0407
(843) 761-7380
Mailing address
501 CARNES CROSSING BLVD STE A, SUMMERVILLE, SC 29486-0407
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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