Healthcare Provider Details

I. General information

NPI: 1851420418
Provider Name (Legal Business Name): ANDREW C OWINGS DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N CAMBRIDGE STREET
NINETY SIX SC
29666-1012
US

IV. Provider business mailing address

321 N CAMBRIDGE STREET
NINETY SIX SC
29666-1012
US

V. Phone/Fax

Practice location:
  • Phone: 864-543-4109
  • Fax: 864-549-3246
Mailing address:
  • Phone: 864-543-4109
  • Fax: 864-549-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2376
License Number StateSC

VIII. Authorized Official

Name: DR. ANDREW COLLIER OWINGS
Title or Position: DENTIST OWNER
Credential: DMD
Phone: 864-543-4109