Organization
FLORENCE SMILES YOUTH DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENELL STUMP (SPECIALIST)
(615) 750-0343
Entity
Organization
Contact information
Practice address
943 S IRBY ST, FLORENCE, SC 29501-5217
(843) 673-0075
(843) 673-0024
Mailing address
16 ARCADE UNIT 198747, NASHVILLE, TN 37219-1994
(615) 750-0343
(615) 986-1705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9556
—
SC
Enumeration date
01/24/2006
Last updated
07/09/2014
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