MIDLANDS PEDIATRIC DENTISTRY LLC NPI 1841667037

NPI Information

MIDLANDS PEDIATRIC DENTISTRY LLC is a pediatric dentistry dentist in Lexington, 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. MIDLANDS PEDIATRIC DENTISTRY LLC NPI is 1841667037. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

253 CEDARCREST DR
LEXINGTON, SC
ZIP 29072-812
Phone: (803) 951-7337

The provider's authorized official is Robert Laforrest Shoun .
The authorized official title is Dentist/owner and has the following contact phone number (803) 348-8976.

The CLIA number assigned to this NPI record is 42D2130429 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2015 and was last updated on 8/24/2015.

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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