Organization
FOUNTAIN INN DENTAL, LLC
Active
Other names
Fountain Inn Dental
Organization subpart
No
Provider details
NPI number
Authorized official
VIKAS R. JAIN DMD (OWNER)
(706) 877-4110
Entity
Organization
Contact information
Practice address
1125 N MAIN ST, FOUNTAIN INN, SC 29644-1322
(864) 409-7733
Mailing address
1125 N MAIN ST, FOUNTAIN INN, SC 29644-1322
(864) 409-7733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/02/2017
Last updated
07/21/2022
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