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General NPI Number Information
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NPI Number | 1235678301
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Entity Type | Organization
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Legal Business Name | GILDNER FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 602 E MAIN ST E
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City | LEXINGTON
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State | SC
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Zip | 29072-3729
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Country | US
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Telephone | 803-622-5173
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Fax |
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Provider Business Mailing Address
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Address Line | 602 E MAIN ST E
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City | LEXINGTON
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State | SC
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Zip | 29072-3729
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Country | US
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Telephone | 803-622-5173
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Fax |
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Authorized Official
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Title or Position | OWNDER
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Name | DR. ROBERT KENNY GILDNER
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Credential | DMD
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Telephone | 803-622-5173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8527
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License Number State | SC
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