Organization
PALMETTO SURGICAL CONSULTANTS ASSOCIATION,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACE H RUTHERFORD D.D.S. (C.E.O.)
(803) 256-4304
Entity
Organization
Contact information
Practice address
1330 GREGG ST, COLUMBIA, SC 29201-3526
(803) 256-4304
Mailing address
1330 GREGG ST, COLUMBIA, SC 29201-3526
(803) 256-4304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
SC
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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