Eau Claire Family Dentistry
LBN: Eau Claire Cooperative Health Center, Inc.
Eau Claire Family Dentistry is an health care organization with primary practice located at 3800 N Main St Ste. C, Columbia SC 29203-6414. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Dental Providers / General Practice is the primary health care specialty.
Eau Claire Cooperative Health Center, Inc. can be contacted via phone (803) 705-3169, or through Cantave, Delgaod via phone (803) 733-5969.
Contact Information
Primary practice address
3800 N Main St Ste. C
Columbia SC 29203-6414
Phone: (803) 705-3169
Fax: (803) 705-3175
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1457740789 |
|---|---|
| LBN Legal business name | Eau Claire Cooperative Health Center, Inc. |
| DBA Doing business as | Eau Claire Family Dentistry |
| Authorized official | Cantave, Delgaod |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 9th, 2015 |
| Last updated | Feb 3rd, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457740789 | NPPES |
| South Carolina | MEDICAID | ZA9183 |
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