| Children And Adult Dental Group | |
|
1118 Greenlawn Dr Columbia SC 29209-2606 | |
| (803) 807-2140 | |
| Not Available |
| Full Name | Children And Adult Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1118 Greenlawn Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Tonia Patterson (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 8036007211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children And Adult Dental Group 7457 Patterson Rd Ste 107 Columbia SC 29209-0710 Ph: (803) 807-2140 | Children And Adult Dental Group 1118 Greenlawn Dr Columbia SC 29209-2606 Ph: (803) 807-2140 |
| NPI Number | 1225456247 |
|---|---|
| Provider Enumeration Date | 04/07/2014 |
| Last Update Date | 10/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225456247 | NPI | - | NPPES |
| Z29050 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2905 (South Carolina) | Primary |
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