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General NPI Number Information
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NPI Number | 1790159465
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Entity Type | Organization
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Legal Business Name | DELITE DENTAL
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 320 MIDLAND PKWY STE A
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City | SUMMERVILLE
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State | SC
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Zip | 29485-7197
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Country | US
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Telephone | 843-212-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 320 MIDLAND PKWY STE A
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City | SUMMERVILLE
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State | SC
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Zip | 29485-7195
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER OF DELITE DENTAL
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Name | DR. HAYAN LEE
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Credential |
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Telephone | 843-212-6565
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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 | 8287
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License Number State | SC
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