Organization
WILD SMILES WHITE KNOLL FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUNJIT RICK SINGH D.M.D (OWNER)
(803) 356-1606
Entity
Organization
Contact information
Practice address
1767 S LAKE DR, SUITE # A, LEXINGTON, SC 29073-6734
(803) 356-1606
(803) 359-7542
Mailing address
1767 S LAKE DR, SUITE # A, LEXINGTON, SC 29073-6734
(803) 356-1606
(803) 359-7542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
SC3864
SC
1223P0221X
Pediatric Dentistry
Primary
SC3351
SC
1223P0221X
Pediatric Dentistry
SC3801
SC
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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