Organization
ORANGEBURG FAMILY DENTISTRY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE D. HARTZOG (OFFICE MANAGER)
(803) 536-6440
Entity
Organization
Contact information
Practice address
695 LAUREL ST, ORANGEBURG, SC 29115-4834
(803) 536-6440
(803) 268-9921
Mailing address
695 LAUREL ST, ORANGEBURG, SC 29115-4834
(803) 536-6440
(803) 268-9921
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1836
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9827
—
SC
Enumeration date
12/12/2006
Last updated
12/26/2007
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