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General NPI Number Information
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NPI Number | 1295793289
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Entity Type | Organization
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Legal Business Name | DENTAL ASSOCIATES OF EASLEY, PA
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 415 S PENDLETON ST
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City | EASLEY
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State | SC
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Zip | 29640-3051
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Country | US
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Telephone | 864-859-0111
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Fax | 864-859-0112
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Provider Business Mailing Address
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Address Line | 415 S PENDLETON ST
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City | EASLEY
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State | SC
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Zip | 29640-3051
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Country | US
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Telephone | 864-859-0111
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF OPERATIONS
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Name | DARLA LUCAS
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Credential |
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Telephone | 864-523-5771
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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