Organization
CAROLINA PROFESSIONAL DENTISTRY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE RESPASS (CEO)
(803) 396-5888
Entity
Organization
Contact information
Practice address
200 DOBYS BRIDGE RD, SUITE 108, FORT MILL, SC 29715-2083
(803) 396-5888
(803) 396-5893
Mailing address
200 DOBYS BRIDGE RD, SUITE 108, FORT MILL, SC 29715-2083
(803) 396-5888
(803) 396-5893
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4401
SC
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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