| Palmetto Dental | |
|
1578 Constitution Blvd Ste 01 Rock Hill SC 29732-3543 | |
| (803) 366-1456 | |
| (803) 324-0117 |
| Full Name | Palmetto Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1578 Constitution Blvd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Jae Sung Park (PRESIDENT) |
| Authorized Official Contact | 8033661456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Dental 1578 Constitution Blvd Ste 01 Rock Hill SC 29732-3543 Ph: (803) 366-1456 | Palmetto Dental 1578 Constitution Blvd Ste 01 Rock Hill SC 29732-3543 Ph: (803) 366-1456 |
| NPI Number | 1275908923 |
|---|---|
| Provider Enumeration Date | 12/07/2015 |
| Last Update Date | 12/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275908923 | NPI | - | NPPES |
| ZX8288 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8288 (South Carolina) | Primary |
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