Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Active
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Other names
Edgewater Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
1028 EDGEWATER CORP. PKWY, SUITE 101, INDIAN LAND, SC 29707
(803) 399-7659
Mailing address
1028 EDGEWATER CORP. PKWY, SUITE 101, INDIAN LAND, SC 29707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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