Organization
CAROLINA ROOTS DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERRY GEORGE DMD (DENTIST)
(864) 631-6644
Entity
Organization
Contact information
Practice address
9905 CALVIN HALL ROAD, 100, INDIAN LAND, SC 29707
(864) 631-6644
Mailing address
2038 COUNTRY MANOR DR, MT PLEASANT, SC 29466-7410
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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