Organization
VICTORY DENTISTRY FOR KIDS
Active
Other names
Victory Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
TASHIA MCDONALD (MANAGER)
(803) 228-0525
Entity
Organization
Contact information
Practice address
9787 CHARLOTTE HWY STE 203, INDIAN LAND, SC 29707-5511
(803) 547-2280
Mailing address
9787 CHARLOTTE HWY STE 203, INDIAN LAND, SC 29707-5511
(803) 547-2280
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
4382
SC
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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