Organization
HOLLY TREE FAMILY DENTAL
Active
Other names
Holly Tree Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANN M BYNUM DDS (VICE PRESIDENT)
(864) 442-6770
Entity
Organization
Contact information
Practice address
1673 E MAIN ST, EASLEY, SC 29640-3791
(864) 442-6770
(864) 442-6830
Mailing address
1673 E MAIN ST, EASLEY, SC 29640-3791
(864) 442-6770
(864) 442-6830
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3427
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9157
—
SC
Enumeration date
01/06/2016
Last updated
01/06/2016
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