Carolina Forest Periodontics, Pa

NPI 1063639888 - Dentist - 1223P0300X

NPI Details
NPI 1063639888
Enumeration Date 04/20/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name ALLEN ALLEN
Position PRESIDENT
Phone (843) 650-8000
Fax (843) 347-4920
Practice Location
1074 HIGHWAY 501 BUSINESS
CONWAY SC, 29526-9588, US
Phone (843) 650-8000
Fax (843) 347-4920
Business Location
1074 HIGHWAY 501 BUSINESS
CONWAY SC, 29526-9588, US
Phone (843) 650-8000
Fax (843) 347-4920
Toxanomy
Taxonomy Code 1223P0300X
License State South Carolina
License Number 2434
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According to our database, Carolina Forest Periodontics, Pa NPI is 1063639888, taxonomy code is 1223P0300X and license number is 2434, license state is located at South Carolina. Carolina Forest Periodontics, Pa physically located at 1074 Highway 501 Business, Conway SC, 29526-9588. NPI Number 1033115704 has the healthcare provider type.

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1063639888 NPI number is provided on an as is basis without warranty of any kind. 1063639888 is maintained by the National Plan & Provider Enumeration System. The contents of Carolina Forest Periodontics, Pa are for informational purposes only.