| Columbia Dental Associates | |
|
2007 Broad River Rd Columbia SC 29210-7006 | |
| (803) 772-1548 | |
| Not Available |
| Full Name | Columbia Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2007 Broad River Rd, Columbia, South Carolina |
| Authorized Official Name and Position | Benjamin Sheftall (OWNER) |
| Authorized Official Contact | 8037721548 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Dental Associates 2007 Broad River Rd Columbia SC 29210-7006 Ph: (803) 772-1548 | Columbia Dental Associates 2007 Broad River Rd Columbia SC 29210-7006 Ph: (803) 772-1548 |
| NPI Number | 1982773669 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982773669 | NPI | - | NPPES |
| 576571 | Other | SC | MILLITARY |
| Z12816 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 200639953147 (South Carolina) | Primary |
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