Organization
SOUTHERN ROOTS PERIODONTICS: IMPLANT & LASER DENTISTRY, LLC
Active
Other names
South Carolina Periodontology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW JOSEPH ROWE D.D.S., M.S.D. (OWNER/MANAGER)
(803) 782-0528
Entity
Organization
Contact information
Practice address
2120 N BELTLINE BLVD, COLUMBIA, SC 29204-4518
(803) 782-0528
(803) 782-1036
Mailing address
2120 N BELTLINE BLVD, COLUMBIA, SC 29204-4518
(803) 782-0528
(803) 782-1036
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8489
SC
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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