Organization
SUNNYSIDE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIKA AGU DDS (CEO)
(864) 715-2227
Entity
Organization
Contact information
Practice address
1500 W MAIN ST UNIT 110, LAURENS, SC 29360-3767
(864) 715-2227
Mailing address
119 YOUNG HARRIS DR, SIMPSONVILLE, SC 29681-8115
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7101
SC
Other
Enumeration date
05/30/2017
Last updated
05/30/2017
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