Organization
FT MILL DENTISTRY LLC
Active
Other names
Fort Mill Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY DEAN (OFFICE ADMINISTRATOR)
(803) 547-7508
Entity
Organization
Contact information
Practice address
133 CLEBOURNE ST, FORT MILL, SC 29715-1742
(803) 547-7508
(803) 547-1070
Mailing address
PO BOX 489, FORT MILL, SC 29716-0489
(803) 547-7508
(803) 547-1070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4178
SOUTH CAROLINA BOARD OF DENTISTRY
SC
01
—
4481
SOUTH CAROLINA BOARD OF DENTISTRY
SC
Enumeration date
09/15/2021
Last updated
09/15/2021
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