Organization
JOHN C COSBY JR DMD PA
Active
Other names
Blythwood Village Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C COSBY JR. DMD (OWNER PRESIDENT)
(803) 754-9160
Entity
Organization
Contact information
Practice address
745 UNIVERSITY VILLAGE DRIVE, BLYTHEWOOD, SC 29016
(803) 754-9160
(803) 754-9162
Mailing address
PO BOX 969, BLYTHEWOOD, SC 29016
(803) 754-9160
(803) 754-9162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC1677
SC
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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