University Dental Pa

NPI 1568673069 - Dentist - 122300000X

NPI Details
NPI 1568673069
Enumeration Date 05/25/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LORETTA KAY LORETTA
Position OWNER PRESIDENT CEO
Phone (803) 252-8101
Fax (803) 779-7721
Practice Location
2329 DEVINE STREET
COLUMBIA SC, 29250, US
Phone (803) 252-8101
Fax (803) 779-7721
Business Location
PO BOX 50664
2329 DEVINE STREET
COLUMBIA SC, 29250, US
Phone (803) 252-8101
Fax (803) 779-7721
Toxanomy
Taxonomy Code 122300000X
License State Georgia
License Number DN013211
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According to our database, University Dental Pa NPI is 1568673069, taxonomy code is 122300000X and license number is DN013211, license state is located at Georgia. University Dental Pa physically located at 2329 Devine Street, Columbia SC, 29250. NPI Number 1033115704 has the healthcare provider type.

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1568673069 NPI number is provided on an as is basis without warranty of any kind. 1568673069 is maintained by the National Plan & Provider Enumeration System. The contents of University Dental Pa are for informational purposes only.