Individual
DR. EDGAR HAROLD PEACOCK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2750 LAUREL ST, STE 202, COLUMBIA, SC 29204-2024
(803) 256-9268
(803) 256-0084
Mailing address
2750 LAUREL ST, STE 202, COLUMBIA, SC 29204-2024
(803) 256-9268
(803) 256-0084
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1545
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z15458
—
SC
05
—
ZA9549
—
SC
Enumeration date
05/24/2005
Last updated
03/19/2013
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