Healthcare Provider Details

I. General information

NPI: 1588574909
Provider Name (Legal Business Name): THE PALMS DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LAKE MURRAY BLVD
COLUMBIA SC
29212-8623
US

IV. Provider business mailing address

1600 LAKE MURRAY BLVD
COLUMBIA SC
29212-8623
US

V. Phone/Fax

Practice location:
  • Phone: 803-604-4440
  • Fax:
Mailing address:
  • Phone: 803-604-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARI M LEE
Title or Position: OFFICE MANAGER
Credential:
Phone: 803-260-0975