NORTHEAST CHILDRENS DENTISTRY NPI 1598094138

NPI Information

NORTHEAST CHILDRENS DENTISTRY is a pediatric dentistry dentist in Columbia, SC. The provider is 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. NORTHEAST CHILDRENS DENTISTRY NPI is 1598094138. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

147 SUMMIT CENTRE DR.
COLUMBIA, SC
ZIP 29229
Phone: (803) 865-1421
Fax: (866) 415-7943

The provider's authorized official is Chrislyn Earline Lawhon .
The authorized official title is Dentist/owner and has the following contact phone number (803) 865-1421.

The CLIA number assigned to this NPI record is 42D2109753 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2009 and was last updated on 12/10/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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