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General NPI Number Information
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NPI Number | 1609988005
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Entity Type | Organization
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Legal Business Name | PALMETTO ORTHODONTICS, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2076B WOODRUFF RD
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City | GREENVILLE
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State | SC
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Zip | 29607-5939
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Country | US
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Telephone | 864-234-7357
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Fax | 864-627-8316
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Provider Business Mailing Address
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Address Line | 2076B WOODRUFF RD
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City | GREENVILLE
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State | SC
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Zip | 29607-5939
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Country | US
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Telephone | 864-234-7357
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Fax | 864-627-8316
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES DAVID ATKINSON
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Credential | DDS, MSD
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Telephone | 864-234-7357
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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 | 1613
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License Number State | SC
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