Organization
MIDLANDS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY D RICKBORN DMD (OWNER)
(803) 731-0803
Entity
Organization
Contact information
Practice address
2844 SUNSET BLVD, WEST COLUMBIA, SC 29169-3420
(803) 731-0803
Mailing address
2844 SUNSET BLVD, WEST COLUMBIA, SC 29169-3420
(803) 731-0803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC2345
SC
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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