| Crystal Smiles Pc | |
|
1412 Barnwell St Columbia SC 29201-3512 | |
| (803) 256-2333 | |
| (803) 256-1580 |
| Full Name | Crystal Smiles Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1412 Barnwell St, Columbia, South Carolina |
| Authorized Official Name and Position | Crystal L. Johnson (DOCTOR/OWNER) |
| Authorized Official Contact | 8032562333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Smiles Pc 1412 Barnwell St Columbia SC 29201-3512 Ph: (803) 256-2333 | Crystal Smiles Pc 1412 Barnwell St Columbia SC 29201-3512 Ph: (803) 256-2333 |
| NPI Number | 1700075041 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700075041 | NPI | - | NPPES |
| ZA9587 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (South Carolina) | Primary |
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