Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Other names
Prestwood Complete Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Authorized official
KIM WILSON (CRED. SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
214 W HOME AVE, HARTSVILLE, SC 29550-4126
(843) 332-1331
(843) 857-9359
Mailing address
214 W HOME AVE, HARTSVILLE, SC 29550-4126
(843) 332-1331
(843) 857-9359
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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