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Organization

UNIVERSITY DENTAL PA

Active
Other names
University Dental LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LORETTA KAY FELDER MCKELVEY DDS (OWNER PRESIDENT CEO)
(803) 252-8101
Entity
Organization

Contact information

Practice address
2329 DEVINE STREET, COLUMBIA, SC 29250
(803) 252-8101
(803) 779-7721
Mailing address
PO BOX 50664, 2329 DEVINE STREET, COLUMBIA, SC 29250
(803) 252-8101
(803) 779-7721

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401411265
VA
122300000X
Dentist
DN013211
GA
122300000X
Dentist
Primary
SC2642
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZ2642
SC
Enumeration date
05/25/2007
Last updated
08/22/2020
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