Dominguez, Lori Christina
Dominguez, Lori Christina is an individual health care provider with primary practice located at 575 Springcrest Dr Suite A, Fort Mill SC 29715-7324. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Dominguez, Lori Christina can be contacted via phone (803) 547-1888.Contact Information
Primary practice address
575 Springcrest Dr Suite A
Fort Mill SC 29715-7324
Phone: (803) 547-1888
Fax: (803) 547-8533
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 3850 | South Carolina |
Profile Details
| NPI number | 1558341479 |
|---|---|
| LBN Legal business name | Dominguez, Lori Christina |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Sep 15th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558341479 | NPPES |
| South Carolina | MEDICAID | 2X3850 | |
| South Carolina | MEDICAID | 5900546 |
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