360care LLC
Dentist, General Practice in Columbia, SC. Organization (NPI-2).
NPI number1336760909
StatusActive
Last updated in NPPESMay 5, 2020
Details
- NPI
- 1336760909
- Entity type
- Organization (NPI-2)
- Legal business name
- 360care LLC
- Organization subpart
- No
- Enumeration date
- May 5, 2020
- Certification date
- May 5, 2020
- Last updated
- May 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
1703 Laurel StColumbia, SC 29201-2660
Phone 502-244-2420 · Fax 502-996-8282
Mailing address
12910 Shelbyville Rd Ste 300Louisville, KY 40243-2404
Phone 502-244-2420 · Fax 502-996-8282
Authorized official
Joy L Stevens
Director Of Credentialing
5022442441
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