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General NPI Number Information
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NPI Number | 1538516042
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Entity Type | Organization
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Legal Business Name | RIVER FALLS PEDITRIC DENTISTRY, PA
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 505 SQUIRES PT
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City | DUNCAN
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State | SC
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Zip | 29334-8867
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Country | US
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Telephone | 864-433-6888
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Fax | 864-433-6889
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Provider Business Mailing Address
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Address Line | 505 SQUIRES PT
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City | DUNCAN
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State | SC
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Zip | 29334-8867
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Country | US
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Telephone | 864-433-6888
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Fax | 864-433-6889
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Authorized Official
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Title or Position | OWNER
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Name | DR. AUNCHANA TOCHAROEN
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Credential | DMD
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Telephone | 864-433-6888
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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 | 3620
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License Number State | SC
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