Organization
ELITE SMILES DENTAL, PA
Active
Parent organization
ELITE SMILES DENTAL, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELITE SMILES DENTAL, PA
Authorized official
ANDREW GERALD GAMBRELL DMD (PRESIDENT)
(803) 419-5002
Entity
Organization
Contact information
Practice address
9020 FARROW RD, COLUMBIA, SC 29203-9773
(803) 419-5002
(803) 419-9600
Mailing address
9020 FARROW RD, COLUMBIA, SC 29203-9773
(803) 419-5002
(803) 419-9600
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
12/19/2019
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