Organization
PARK PLACE DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CINDY NICHOLS (DENTIST/ OWNER)
(864) 482-2400
Entity
Organization
Contact information
Practice address
203B CENTRAL PARK LN, SENECA, SC 29678-1156
(864) 482-2400
(864) 482-2404
Mailing address
203B CENTRAL PARK LN, SENECA, SC 29678-1156
(864) 482-2400
(864) 482-2404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1109
SC
122300000X
Dentist
Primary
4218
SC
124Q00000X
Dental Hygienist
493
SC
124Q00000X
Dental Hygienist
8328
SC
Other
Enumeration date
09/28/2010
Last updated
10/15/2010
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