| Dental Wellness Center Of Irmo, Llc | |
|
2724 N Lake Dr Ste 304 Columbia SC 29212-8733 | |
| (888) 885-8492 | |
| (912) 226-3489 |
| Full Name | Dental Wellness Center Of Irmo, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2724 N Lake Dr Ste 304, Columbia, South Carolina |
| Authorized Official Name and Position | Christie D Lawrence (CORPORATE OPERATIONS COORDINATOR) |
| Authorized Official Contact | 9129205577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Wellness Center Of Irmo, Llc Po Box 60339 Savannah GA 31420-0339 Ph: (888) 885-8492 | Dental Wellness Center Of Irmo, Llc 2724 N Lake Dr Ste 304 Columbia SC 29212-8733 Ph: (888) 885-8492 |
| NPI Number | 1407314404 |
|---|---|
| Provider Enumeration Date | 03/08/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407314404 | NPI | - | NPPES |
| 1497918759 | Other | GA | NPI |
| DN010747 | Other | GA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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