Organization
CAROLINA AESTHETIC DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE MELISSA NICHOLSON DMD (DENTIST)
(864) 577-9400
Entity
Organization
Contact information
Practice address
383 SOUTH PINE STREET, SUITE 3, SPARTANBURG, SC 29302
(864) 577-9400
(864) 577-9773
Mailing address
383 SOUTH PINE STREET, SUITE 3, SPARTANBURG, SC 29302
(864) 577-9400
(864) 577-9773
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
SC3390
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233900
—
SC
05
—
ZA9539
—
SC
Enumeration date
08/25/2006
Last updated
08/22/2020
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