Carolina Avenue Dental
Dentist, General Practice in Moncks Corner, SC. Organization (NPI-2).
NPI number1023116019
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1023116019
- Entity type
- Organization (NPI-2)
- Legal business name
- Carolina Avenue Dental
- Organization subpart
- No
- Enumeration date
- Sep 21, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | SC3281 | SC | Yes |
Practice location
214 Carolina AvenueMoncks Corner, SC 29461
Phone 843-899-5911 · Fax 843-899-5961
Mailing address
214 Carolina AvenueMoncks Corner, SC 29461
Phone 843-899-5911 · Fax 843-899-5968
Authorized official
Gloria B Pipkin
President
8438995911
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