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General NPI Number Information
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NPI Number | 1023708617
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Entity Type | Organization
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Legal Business Name | FLORENCE-DARLINGTON TECHNICAL COLLEGE
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 320 W CHEVES ST
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City | FLORENCE
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State | SC
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Zip | 29501-4437
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Country | US
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Telephone | 843-679-2032
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100548
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City | FLORENCE
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State | SC
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Zip | 29502-0548
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERMAINE FORD
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Credential |
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Telephone | 843-661-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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