Columbia Periodontal Assoicates, Llc

LBN: Columbia Periodontal Assoicates, Llc
Columbia Periodontal Assoicates, Llc is an health care organization with primary practice located at 3527 Bush River Rd , Columbia SC 29210-4805. The organization recently has only one registered license in Dental Providers / Periodontics, which is considered as the primary health care specialty. Columbia Periodontal Assoicates, Llc can be contacted via phone (803) 798-0894, or through Mathis, Laurel-Jean M via phone (803) 798-0894.

Contact Information

Primary practice address
3527 Bush River Rd Columbia SC 29210-4805
Phone: (803) 798-0894
Fax: (803) 731-7887
Website:
Map and Directions
Authorized official contact:
Name: Mathis, Laurel-Jean M Registered Dental Hygienist (RDH)
Phone: (803) 798-0894

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X

Profile Details

NPI number 1548282130
LBN Legal business name Columbia Periodontal Assoicates, Llc
DBA Doing business as
Authorized official Mathis, Laurel-Jean M Registered Dental Hygienist (RDH)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 24th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548282130 NPPES
South Carolina MEDICAID ZA9736

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