| Indigo Pediatric Dentistry | |
|
1673 E Main St Unit B Easley SC 29640-3791 | |
| (864) 442-6770 | |
| (864) 442-6830 |
| Full Name | Indigo Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1673 E Main St Unit B, Easley, South Carolina |
| Authorized Official Name and Position | Rula M Shalabi (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 8644426770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Pediatric Dentistry 1673 E Main St Unit B Easley SC 29640-3791 Ph: (864) 525-7838 | Indigo Pediatric Dentistry 1673 E Main St Unit B Easley SC 29640-3791 Ph: (864) 442-6770 |
| NPI Number | 1174082713 |
|---|---|
| Provider Enumeration Date | 03/13/2019 |
| Last Update Date | 03/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174082713 | NPI | - | NPPES |
| ZX8355 | Medicaid | SC | |
| 1609282425 | Other | SC | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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