Organization
THREE FOUNTAINS FAMILY DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER D STOLTZ DMD (DENTIST PRESIDENT)
(803) 755-0039
Entity
Organization
Contact information
Practice address
2248 PINE STREET, WEST COLUMBIA, SC 29170
(803) 755-0039
(803) 755-0007
Mailing address
2248 PINE STREET, WEST COLUMBIA, SC 29170
(803) 755-0039
(803) 755-0007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2688
SC
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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