Organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Other names
Gilder Creek Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-8426
Entity
Organization
Contact information
Practice address
2800 WOODRUFF RD, SIMPSONVILLE, SC 29681-4806
(217) 540-5100
Mailing address
2800 WOODRUFF RD, SIMPSONVILLE, SC 29681-4806
(864) 963-7000
(864) 263-7488
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
03/06/2019
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