Organization
PALMS DENTISTRY 225, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN DERRICK (OWNER/DENTIST)
(864) 243-8371
Entity
Organization
Contact information
Practice address
208 HARRISON BRIDGE ROAD, FOUNTAIN INN, SC 29644
(864) 243-8371
(864) 243-8374
Mailing address
208 HARRISON BRIDGE ROAD, FOUNTAIN INN, SC 29644
(864) 243-8371
(864) 243-8374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3949
SC
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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