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General NPI Number Information
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NPI Number | 1487267365
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Entity Type | Organization
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Legal Business Name | CP DENTISTRY, LLC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 9919 DORCHESTER ROAD
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City | SUMMERVILLE
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State | SC
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Zip | 29485
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Country | US
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Telephone | 843-773-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 15 LOWNDES POINTE DRIVE
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City | CHARLESTON
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State | SC
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Zip | 29403
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Country | US
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Telephone | 716-863-8837
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Fax |
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | ERIC VIETH
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Credential | DDS
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Telephone | 716-863-8837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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