114 Kershaw Dental, Pc

NPI 1043699713 - Dentist - 1223G0001X

NPI Details
NPI 1043699713
Enumeration Date 05/27/2015
Last Updated 05/27/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name MATTHEW MATTHEW
Position OWNER
Phone (803) 475-6052
Fax
Practice Location
114 E HILTON ST
KERSHAW SC, 29067-1318, US
Phone (803) 475-6052
Fax
Business Location
PO BOX 330
EDGEFIELD SC, 29824-0330, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State
License Number
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According to our database, 114 Kershaw Dental, Pc NPI is 1043699713, taxonomy code is 1223G0001X 114 Kershaw Dental, Pc physically located at 114 E Hilton St, Kershaw SC, 29067-1318. NPI Number 1033115704 has the healthcare provider type.

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1043699713 NPI number is provided on an as is basis without warranty of any kind. 1043699713 is maintained by the National Plan & Provider Enumeration System. The contents of 114 Kershaw Dental, Pc are for informational purposes only.