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General NPI Number Information
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NPI Number | 1548388168
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Entity Type | Organization
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Legal Business Name | ANDERSON FAMILY DENTAL CARE PA
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1411 NORTH FANT ST
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City | ANDERSON
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State | SC
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Zip | 29621
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Country | US
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Telephone | 864-226-8040
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Fax | 864-225-9965
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Provider Business Mailing Address
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Address Line | 1411 NORTH FANT ST
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City | ANDERSON
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State | SC
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Zip | 29621
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Country | US
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Telephone | 864-226-8040
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Fax | 864-225-9965
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Authorized Official
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Title or Position | DENTIST GENERAL
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Name | DR. JOHN H HOLLINGSWORTH
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Credential | DMD
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Telephone | 864-226-8040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3288
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License Number State | SC
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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 | 3267
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License Number State | SC
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