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General NPI Number Information
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NPI Number | 1821589367
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Entity Type | Organization
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Legal Business Name | GENTLE DENTISTRY OF LEXINGTON, LLC
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 109 TIMBERMILL DR
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City | LEXINGTON
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State | SC
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Zip | 29073-7138
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Country | US
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Telephone | 803-957-2297
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Fax | 803-957-4178
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Provider Business Mailing Address
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Address Line | 109 TIMBERMILL DR
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City | LEXINGTON
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State | SC
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Zip | 29073-7138
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Country | US
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Telephone | 803-957-2297
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Fax | 803-957-4178
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Authorized Official
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Title or Position | ADMIN ASST
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Name | MRS. MARY A DEWITT
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Credential | CDA
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Telephone | 803-957-2297
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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 |
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License Number State |
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