Organization
VSM COLUMBIA PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL WALKER (CREDENTIALING COORDINATOR)
(404) 410-1343
Entity
Organization
Contact information
Practice address
2302 BUSH RIVER RD, COLUMBIA, SC 29210-5649
(803) 798-8675
Mailing address
2302 BUSH RIVER RD, COLUMBIA, SC 29210-5649
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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