Organization
POUGH DENTISTRY
Active
Other names
University Dental PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAKEEBA BOOKHART POUGH DMD (OWNER/MEMBER)
(803) 260-0807
Entity
Organization
Contact information
Practice address
3126 DEVINE ST, COLUMBIA, SC 29205-1846
(803) 252-8101
(803) 779-7721
Mailing address
276 TUFTON CT, CAYCE, SC 29033-2742
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
09/21/2023
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