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General NPI Number Information
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NPI Number | 1821140617
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Entity Type | Organization
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Legal Business Name | EAST END DENTAL CLINIC, PC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 W OAK HWY
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City | WESTMINSTER
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State | SC
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Zip | 29693-2226
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Country | US
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Telephone | 864-647-9000
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Fax | 864-647-7873
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Provider Business Mailing Address
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Address Line | 104 W OAK HWY
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City | WESTMINSTER
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State | SC
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Zip | 29693-2226
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Country | US
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Telephone | 864-647-9000
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Fax | 864-647-7873
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEBBIE SMITH
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Credential |
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Telephone | 864-647-9000
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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 | SC1143
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License Number State | SC
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