Organization
INDIGO DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RAINS (MANAGER)
(803) 348-7401
Entity
Organization
Contact information
Practice address
121 ALPINE CIR, COLUMBIA, SC 29223-6385
(803) 348-7401
Mailing address
862 RUTLEDGE AVE, CHARLESTON, SC 29403-3434
(803) 348-7401
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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