| Lakeside Family Dentistry, Llc | |
|
4371 Highway 24 Anderson SC 29626-5214 | |
| (864) 305-1402 | |
| Not Available |
| Full Name | Lakeside Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4371 Highway 24, Anderson, South Carolina |
| Authorized Official Name and Position | Thomas Miller (OWNER) |
| Authorized Official Contact | 8643051402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Dentistry, Llc 4371 Highway 24 Anderson SC 29626-5214 Ph: () - | Lakeside Family Dentistry, Llc 4371 Highway 24 Anderson SC 29626-5214 Ph: (864) 305-1402 |
| NPI Number | 1346680725 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 06/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346680725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4489 (South Carolina) | Primary |
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