Organization
LAKESHORE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALP JUTHANI (DENTIST)
(803) 396-0000
Entity
Organization
Contact information
Practice address
1200 GOLD HILL RD STE 101, FORT MILL, SC 29708-6916
(803) 396-0000
Mailing address
1200 GOLD HILL RD STE 101, FORT MILL, SC 29708-6916
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/19/2024
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