Organization
LIFETIME FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZANNE M LOWRY (OFFICE MANAGER)
(864) 984-6888
Entity
Organization
Contact information
Practice address
310 OWINGS ST, LAURENS, SC 29360-2738
(864) 984-6888
(864) 984-4474
Mailing address
310 OWINGS ST, LAURENS, SC 29360-2738
(864) 984-6888
(864) 984-4474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3380
SC
1223G0001X
General Practice Dentistry
4036
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9540
—
SC
Enumeration date
12/21/2005
Last updated
08/22/2020
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