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General NPI Number Information
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NPI Number | 1306118815
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Entity Type | Organization
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Legal Business Name | DENTAL ASSOCIATES OF ROCK HILL CROSSING, P.C.
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 4891 OLD YORK RD. SUITE #104
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City | ROCK HILL
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State | SC
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Zip | 29732-8376
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Country | US
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Telephone | 803-326-0100
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Fax | 216-584-1155
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Provider Business Mailing Address
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Address Line | PO BOX 860036
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0036
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Country | US
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Telephone | 803-326-0100
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Fax | 216-584-1155
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MR. CHARLES ZASSO
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Credential | DDS
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Telephone | 803-326-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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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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