| Capital Children's Dental Center, Llc | |
|
655 Saint Andrews Rd Suite 8 Columbia SC 29210-5112 | |
| (803) 252-7725 | |
| Not Available |
| Full Name | Capital Children's Dental Center, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 655 Saint Andrews Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Kevin Raines (PARTNER) |
| Authorized Official Contact | 8039519100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Children's Dental Center, Llc 139 Whiteford Way Lexington SC 29072-7965 Ph: (803) 951-9100 | Capital Children's Dental Center, Llc 655 Saint Andrews Rd Suite 8 Columbia SC 29210-5112 Ph: (803) 252-7725 |
| NPI Number | 1174739056 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174739056 | NPI | - | NPPES |
| ZA9467 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (South Carolina) | Primary |
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