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NPI Code Detail

MEDICARE: DENTISTRY FOR CHILDREN OF SOUTH CAROLINA PC

MEDICARE: DENTISTRY FOR CHILDREN OF SOUTH CAROLINA PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1063901692
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTISTRY FOR CHILDREN OF SOUTH CAROLINA PC
Provider Business Mailing Address
First Line : 2970 BRANDYWINE RD STE 200
Second Line :
City : ATLANTA
State : GA
Zip : 30341-5549
Country : US
Telephone Number : 770-692-1000
Fax Number :
Provider Business Practice Location Address
First Line : 996 TANNER FORD BLVD
Second Line :
City : HANAHAN
State : SC
Zip : 29410-4780
Country : US
Telephone Number : 843-818-5437
Fax Number :
Authorized Official
Title or Position : CREDENTIALING DIRECTOR
Name : JO ANN RICE
Credential :
Telephone Number : 470-881-8679
Provider Enumeration Date : 05/09/2018
Last Update Date : 11/28/2025

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Directions to “DENTISTRY FOR CHILDREN OF SOUTH CAROLINA PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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