Organization
FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER STATHAKIS (CFO)
(312) 274-0308
Entity
Organization
Contact information
Practice address
2022-2024 CHERRY ROAD, ROCK HILL, SC 29732-2627
(803) 324-9400
Mailing address
2022-2024 CHERRY ROAD, ROCK HILL, SC 29732-2627
(803) 324-9400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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