Healthcare Provider Details
I. General information
NPI: 1932690989
Provider Name (Legal Business Name): AFFINITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2018
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
455 LAKESHORE PKWY
ROCK HILL SC
29730-4205
US
IV. Provider business mailing address
455 LAKESHORE PKWY
ROCK HILL SC
29730-4205
US
V. Phone/Fax
- Phone: 803-909-6363
- Fax: 877-658-8669
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
HEATHER
MCCUTCHEON
Title or Position: CEO
Credential:
Phone: 803-909-9710