Organization
FLEETWOOD SQUARE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONIA KAKKAR DDS (MBR)
(864) 855-2788
Entity
Organization
Contact information
Practice address
105 FLEETWOOD DR, EASLEY, SC 29640-2019
(864) 855-2788
(864) 855-2689
Mailing address
105 FLEETWOOD DR, EASLEY, SC 29640-2019
(864) 855-2788
(864) 855-2789
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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