Lotus Dental Associates LLC
Clinic/Center, Dental in Fort Mill, SC. Organization (NPI-2).
NPI number1730740887
StatusActive
Last updated in NPPESJun 27, 2019
Details
- NPI
- 1730740887
- Entity type
- Organization (NPI-2)
- Legal business name
- Lotus Dental Associates LLC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2019
- Last updated
- Jun 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1365 Broadcloth St Ste 204Fort Mill, SC 29715-4507
Phone 803-548-8858 · Fax 803-548-8860
Mailing address
1365 Broadcloth St Ste 204Fort Mill, SC 29715-4507
Phone 803-548-8858 · Fax 803-548-8860
Authorized official
Nhung Phan
Owner
8035488858
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