Individual
DR. ANNETTE I RILEY X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
421 BUSH RIVER RD, COLUMBIA, SC 29210-7332
(803) 798-6333
(803) 798-0701
Mailing address
421 BUSH RIVER RD, DUTCH SQUARE CENTER #5, COLUMBIA, SC 29210-7332
(803) 798-6333
(803) 798-0701
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3757
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3757
STATE LICENSE NUMBER
SC
05
—
ZA9559
—
SC
Enumeration date
07/30/2006
Last updated
07/08/2007
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