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General NPI Number Information
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NPI Number | 1558160945
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Entity Type | Organization
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Legal Business Name | CAMDEN PEDIATRIC DENTISTRY, LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 168 WALL ST APT 405
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City | CAMDEN
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State | SC
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Zip | 29020-8061
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Country | US
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Telephone | 803-306-8847
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Fax | 803-615-4294
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Provider Business Mailing Address
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Address Line | 7701 TRENHOLM ROAD EXT
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City | COLUMBIA
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State | SC
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Zip | 29223-1725
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Country | US
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Telephone | 803-306-8847
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Fax |
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. BYUNGDO BRIAN HAN
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Credential | DDS, PHD
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Telephone | 803-306-8847
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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 | 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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