| Northeast Family Dentistry | |
|
7711 Trenholm Road Extension Columbia SC 29223-1725 | |
| (803) 865-2602 | |
| (803) 865-1814 |
| Full Name | Northeast Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 7711 Trenholm Road Extension, Columbia, South Carolina |
| Authorized Official Name and Position | Yolanda Reid Hunter (OWNER) |
| Authorized Official Contact | 8038652602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Family Dentistry 7711 Trenholm Road Extension Columbia SC 29223-1725 Ph: (803) 865-2602 | Northeast Family Dentistry 7711 Trenholm Road Extension Columbia SC 29223-1725 Ph: (803) 865-2602 |
| NPI Number | 1912125782 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 09/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912125782 | NPI | - | NPPES |
| ZA 9746 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3015 (South Carolina) | Primary |
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