| Sfd Kids Llc | |
|
108 Parish Farms Drive Summerville SC 29486 | |
| (843) 871-0842 | |
| Not Available |
| Full Name | Sfd Kids Llc |
|---|---|
| Speciality | Dentist |
| Location | 108 Parish Farms Drive, Summerville, South Carolina |
| Authorized Official Name and Position | Angela Bazzle (OPERATIONS MANAGER) |
| Authorized Official Contact | 8438710842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sfd Kids Llc 1971 N Main St Summerville SC 29486-7820 Ph: (843) 871-0842 | Sfd Kids Llc 108 Parish Farms Drive Summerville SC 29486 Ph: (843) 871-0842 |
| NPI Number | 1013456987 |
|---|---|
| Provider Enumeration Date | 02/13/2017 |
| Last Update Date | 02/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013456987 | NPI | - | NPPES |
| ZX8227 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8227 (South Carolina) | Primary |
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