Organization
GILLIAM FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERICA FRAZIER (OFFICE STAFF)
(803) 286-5858
Entity
Organization
Contact information
Practice address
208 E DUNLAP ST, LANCASTER, SC 29720-2511
(803) 286-5858
(803) 313-9650
Mailing address
208 E DUNLAP ST, P.O. BOX 1114, LANCASTER, SC 29720-2511
(803) 286-5858
(803) 313-9650
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2718
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9811
—
SC
Enumeration date
01/23/2008
Last updated
01/23/2008
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