Organization · Type 2 NPI
Providence Dental Group LLC
Dental Clinic/Center · Simpsonville, SC
NPI number
1760502181
Active
Practice location
220 Bridges Rd
Simpsonville, SC 29681-5700
Fax (864) 675-6447
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | SC 3724 (SC) |
Dental Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1760502181
Providence Dental Group LLC's National Provider Identifier is 1760502181, issued on Mar 30, 2007. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Simpsonville, SC. The record was last updated on Aug 22, 2020.