MEDICARE: CAROLINA DENTAL PARTNERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1811661598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA DENTAL PARTNERS, INC

Provider Business Mailing Address
First Line	:	946 W CAROLINA AVE
Second Line	:
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-4416
Country	:	US
Telephone Number	:	843-383-5126
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 S CLEVELAND ST
Second Line	:
City	:	KERSHAW
State	:	SC
Zip	:	29067-1403
Country	:	US
Telephone Number	:	803-475-9440
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. SHARLA BUSH PRICE
Credential	:	DMD
Telephone Number	:	843-383-5126

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	08/05/2021

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