Organization
PALMETTO DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARAREH V BORHANIAN D.M.D. (OWNER DENTIST)
(803) 581-2080
Entity
Organization
Contact information
Practice address
701 WILSON ST, CHESTER, SC 29706-8568
(803) 581-2080
(803) 581-2084
Mailing address
701 WILSON ST, CHESTER, SC 29706-8568
(803) 581-2080
(803) 581-2084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3101
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9663
—
SC
Enumeration date
01/24/2007
Last updated
08/22/2020
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