Organization
EH DENTAL, LLC
Active
Other names
East Highland Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES PRESTON PAYNE JR. DMD (OWNER)
(864) 226-5058
Entity
Organization
Contact information
Practice address
303 E HIGHLAND AVE STE 105, ANDERSON, SC 29621-4767
(864) 226-5058
Mailing address
303 E HIGHLAND AVE STE 105, ANDERSON, SC 29621-4767
(864) 226-5058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9142
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851834964
—
CA
Enumeration date
08/02/2018
Last updated
08/02/2018
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