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General NPI Number Information
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NPI Number | 1326651209
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Entity Type | Individual
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Provider Name | LAURA BERNITSKY
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 1015 CREEKSIDE MEDICAL DR
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City | YORK
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State | SC
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Zip | 29745-8624
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Country | US
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Telephone | 803-684-9220
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 CREEKSIDE MEDICAL DR
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City | YORK
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State | SC
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Zip | 29745-8624
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Country | US
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Telephone | 803-684-9220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12028
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License Number State | NC
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