MEDICARE: DENTAL WELLNESS CENTER OF FORT MILL, LLC

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
1	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN010747	OTHER	GA	STATE LICENSE
2	1497918759	OTHER	GA	NPI

General Provider Information

NPI Number	:	1245798230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL WELLNESS CENTER OF FORT MILL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 60339
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31420-0339
Country	:	US
Telephone Number	:	912-920-5577
Fax Number	:	912-226-3489

Provider Business Practice Location Address
First Line	:	749 STOCKBRIDGE DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7200
Country	:	US
Telephone Number	:	888-885-8492
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE OPERATIONS COORDINATOR
Name	:	MRS. CHRISTIE D LAWRENCE
Credential	:
Telephone Number	:	912-920-5577

Provider Enumeration Date	:	03/08/2019
Last Update Date	:	06/11/2019

Similar Medicare Providers

1073460242 — MIGUEL ANGEL CRUZ-MORALES RD
Practice Location Address:

773 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 704-316-7760
Practice Fax:

1942409651 — DR. KATRINA HERRING MD
Practice Location Address:

773 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 803-547-5447
Practice Fax: 803-396-0095

1861851883 — GAMBLE DENTALSMART PC
Practice Location Address:

749 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 843-735-6727
Practice Fax:

1639717010 — DENTAL WELLNESS CENTER EB5 INVESTMENT VI LLC
Practice Location Address:

749 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 803-335-5585
Practice Fax:

1538865183 — DRS J LOVELAND AND R WALKER IV, LLC
Practice Location Address:

749 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 704-960-2492
Practice Fax:

1972464899 — NOVANT HEALTH MEDICAL GROUP, LLC
Practice Location Address:

773 STOCKBRIDGE DR
FORT MILL, SC
29708-7200

Practice Phone: 704-316-7760
Practice Fax: 704-316-7761

Directions to “DENTAL WELLNESS CENTER OF FORT MILL, LLC ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.