Organization
ELITE SMILES DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW G GAMBRELL D.M.D (GENERAL DENTIST)
(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
122300000X
Dentist
2116
SC
122300000X
Dentist
30-04295
SC
122300000X
Dentist
Primary
3794
SC
122300000X
Dentist
SC2116
SC
1223G0001X
General Practice Dentistry
03794
SC
Other
Enumeration date
08/27/2008
Last updated
02/21/2017
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