Organization
GD SC COLUMBIA, LLC
Active
Other names
Southern Smiles Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
160 SUMMIT CENTRE DR, COLUMBIA, SC 29229-7612
(803) 699-7224
Mailing address
160 SUMMIT CENTRE DR, COLUMBIA, SC 29229-7612
(803) 699-7224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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