Healthcare Provider Details

I. General information

NPI: 1659654382
Provider Name (Legal Business Name): ARNOLD L. BATCHELOR, JR., D.M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117-A SPRATT STREET
FORT MILL SC
29715
US

IV. Provider business mailing address

117-A SPRATT STREET
FORT MILL SC
29715
US

V. Phone/Fax

Practice location:
  • Phone: 803-548-2191
  • Fax: 803-548-4583
Mailing address:
  • Phone: 803-548-2191
  • Fax: 803-548-4583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2475
License Number StateSC

VIII. Authorized Official

Name: DR. ARNOLD LAVAUGHAN BATCHELOR JR.
Title or Position: DENTIST/PRESIDENT
Credential: D.M.D.
Phone: 803-548-2191