Organization
CITY DENTAL URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE F SHULL JR. DMD (OWNER)
(803) 764-3320
Entity
Organization
Contact information
Practice address
105 N. MAIN ST, WEST COLUMBIA, SC 29169
(803) 764-3320
Mailing address
105 N. MAIN ST, WEST COLUMBIA, SC 29169
(803) 764-3320
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114379898
DENTIST
SC
01
—
1962572701
DENTAL OFFICE
SC
Enumeration date
02/15/2019
Last updated
02/15/2019
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