Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Other names
Devine Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Authorized official
HEATER PRUEMER (CREDENTIALING TEAM LEAD)
(217) 540-8434
Entity
Organization
Contact information
Practice address
621 CHATHAM AVE, COLUMBIA, SC 29205-2734
(803) 256-1817
Mailing address
621 CHATHAM AVE, COLUMBIA, SC 29205-2734
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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