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Organization

PARKWAY DENTISTRY OF ANDERSON, LLC

Active
Other names
Royal Crest Centre for Advanced Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICK RYAN MARCELLO D.M.D. (OWNER)
(864) 225-3763
Entity
Organization

Contact information

Practice address
104 MONTGOMERY DR, ANDERSON, SC 29621-3334
(864) 225-3763
(864) 225-8486
Mailing address
104 MONTGOMERY DR, ANDERSON, SC 29621-3334
(864) 225-3763
(864) 225-8486

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3609
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9525
SC
Enumeration date
01/25/2007
Last updated
12/23/2009
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