Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Other names
Crowfield Dental
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH FISH (CREDENTIALING MANAGER)
(217) 540-5699
Entity
Organization
Contact information
Practice address
102 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8009
(843) 377-0509
Mailing address
102 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8009
(843) 377-0509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1393195
UNITED CONCORDIA
SC
05
—
ZA9634
—
SC
05
—
ZX3808
—
SC
Enumeration date
04/04/2007
Last updated
06/21/2023
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