| South Carolina Community Dentistry Service | |
|
701 Gervais St #150-128 Columbia SC 29201-3066 | |
| (888) 344-0304 | |
| Not Available |
| Full Name | South Carolina Community Dentistry Service |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 701 Gervais St, Columbia, South Carolina |
| Authorized Official Name and Position | Jose Benitez (PRESIDENT) |
| Authorized Official Contact | 8883440304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Community Dentistry Service 701 Gervais St #150-128 Columbia SC 29201-3066 Ph: (888) 344-0304 | South Carolina Community Dentistry Service 701 Gervais St #150-128 Columbia SC 29201-3066 Ph: (888) 344-0304 |
| NPI Number | 1891826327 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891826327 | NPI | - | NPPES |
| ZA9625 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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