Organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Other names
Dental Care on East Main
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Authorized official
KENDRA WALKER (ENROLLMENT TEAM LEAD)
(217) 540-8513
Entity
Organization
Contact information
Practice address
1617 E MAIN ST, EASLEY, SC 29640
(217) 540-8434
Mailing address
1617 E MAIN ST, EASLEY, SC 29640-3791
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/27/2015
Last updated
07/17/2018
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