Healthcare Provider Details

I. General information

NPI: 1811661598
Provider Name (Legal Business Name): CAROLINA DENTAL PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S CLEVELAND ST
KERSHAW SC
29067-1403
US

IV. Provider business mailing address

946 W CAROLINA AVE
HARTSVILLE SC
29550-4416
US

V. Phone/Fax

Practice location:
  • Phone: 803-475-9440
  • Fax:
Mailing address:
  • Phone: 843-383-5126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SHARLA BUSH PRICE
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 843-383-5126