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1212 Hwy 9 Bypass West Lancaster SC 29720 | |
| (803) 716-9623 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1212 Hwy 9 Bypass West, Lancaster, South Carolina |
| Authorized Official Name and Position | Nicole Caride (CREDENTIALING) |
| Authorized Official Contact | 7277842721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2300 Lakeview Parkway, Ste. 250 Alpharetta GA 30009 Ph: (727) 784-2721 | 1212 Hwy 9 Bypass West Lancaster SC 29720 Ph: (803) 716-9623 |
| NPI Number | 1194401901 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194401901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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