Organization · Type 2 NPI

Palmetto Health

Oral and Maxillofacial Surgery (Dentist) · Columbia, SC

NPI number 1104370188 Active

Practice location

10 Richland Medical Park Dr, Suite A
Columbia, SC 29203-6864

Call (803) 434-6567 Map

Fax (803) 434-6299

Mailing address

PO Box 402145
Atlanta, GA 30384-2145

Specialties and licenses

Taxonomy	Code	License
Oral and Maxillofacial Surgery (Dentist) Primary	1223S0112X	None listed

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

18 other providers at this address

Other oral and maxillofacial surgery (dentist) providers in Columbia

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NPI record

NPI: 1104370188
Entity type: Organization (Type 2)
Issued: Aug 8, 2016
Last updated: Aug 8, 2016
Status: Active
Subpart: Yes of Palmetto Health

Other names

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Palmetto Health Dental Clinic · doing business as

Authorized official

Darrell C Coven
Director, Ambulatory Services Finan
(803) 296-7301

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104370188

Palmetto Health's National Provider Identifier is 1104370188, issued on Aug 8, 2016. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Columbia, SC. The record was last updated on Aug 8, 2016.