institution
Powdersville Pediatric Dentistry, Pa
Pediatric Dentist in Easley, South Carolina
NPI 1417965922

Powdersville Pediatric Dentistry, Pa is a Pediatric Dentist based in Easley, SC and is specialized in Pediatric Dentistry. Powdersville Pediatric Dentistry, Pa practices in Easley, SC. The NPI Number for Powdersville Pediatric Dentistry, Pa is 1417965922 and holds a License No. 3152 (South Carolina).

The current practice location address for Powdersville Pediatric Dentistry, Pa is 10705 Anderson Road, Easley, SC and can be reached out via phone at 864-220-5437 and via fax at 864-220-0420.

Location: 10705 Anderson Road, Easley, SC, 29642
institution
Provider Profile Details
NPI Number
1417965922
Provider Name
Powdersville Pediatric Dentistry, Pa
Credential
Provider Entity Type
Organization
Address
10705 Anderson Road, Easley, SC, 29642
Phone Number
864-220-5437
Fax Number
864-220-0420
Provider Enumeration Date
08/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
88009615 01 AL BLUE CROSS BLUE SHIELD
706109 01 UNITED CONCORDIA
214665 01 ANTHEM BLUE CROSS
3126152 01 TN BLUE CROSS BLUE SHIELD
ZA9574 05 SC
institution
Provider Business Practice Location Address Details
Address
10705 Anderson Road
City
State
Zip
29642
Phone Number
864-220-5437
Fax Number
864-220-0420
person
Provider Business Mailing Address Details
Address
10705 Anderson Road
City
State
Zip
29642
Phone Number
864-220-5437
Fax Number
864-220-0420
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
3152 (South Carolina)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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