Family Dental Health Group LLC
Dentist, General Practice in Irmo, SC. Organization (NPI-2).
NPI number1881498053
StatusActive
Last updated in NPPESApr 4, 2025
Details
- NPI
- 1881498053
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Dental Health Group LLC
- Organization subpart
- Yes
- Enumeration date
- Apr 4, 2025
- Certification date
- Apr 4, 2025
- Last updated
- Apr 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Family Dental Health Of Ballentine (Doing Business As)
Practice location
111 Obrian WayIrmo, SC 29063-8776
Phone 803-749-6072
Mailing address
400 Memorial Drive Ext Ste 400Greer, SC 29651-1850
Phone 864-282-1935 · Fax 864-751-6387
Authorized official
Beth Louise Illsley
Director Of Insurance
8642821935
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