Destination Dental Of Duncan LLC
Dentist, General Practice in Duncan, SC. Organization (NPI-2).
NPI number1124635495
StatusActive
Last updated in NPPESSep 30, 2020
Details
- NPI
- 1124635495
- Entity type
- Organization (NPI-2)
- Legal business name
- Destination Dental Of Duncan LLC
- Organization subpart
- No
- Enumeration date
- Sep 30, 2020
- Certification date
- Sep 30, 2020
- Last updated
- Sep 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | |
| 1223P0300X | Dentist, Periodontics | – | – | |
| 1223P0700X | Dentist, Prosthodontics | – | – | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – |
Practice location
155 Deacon Tiller CtDuncan, SC 29334-8880
Phone 864-485-2214 · Fax 864-485-2215
Mailing address
401 Commerce Dr Ste 108Fort Washington, PA 19034-2724
Phone 215-550-4590 · Fax 215-646-6166
Authorized official
Niranjan Savani
Owner
2155504590
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