Organization
CAROLINA DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN J STOLLER DMD (PRESIDENT/OWNER)
(864) 288-6404
Entity
Organization
Contact information
Practice address
132 MILESTONE WAY, GREENVILLE, SC 29615-5065
(864) 288-6404
(864) 288-2515
Mailing address
132 MILESTONE WAY, GREENVILLE, SC 29615-5065
(864) 288-6404
(864) 288-2515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3444
SC
Other
Enumeration date
02/21/2008
Last updated
02/21/2008
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