Riverside Pediatric Dentistry Llc

LBN: Riverside Pediatric Dentistry Llc
Riverside Pediatric Dentistry Llc is an health care organization with primary practice located at 461 W Cheves St , Florence SC 29501-4446. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Riverside Pediatric Dentistry Llc can be contacted via phone (843) 601-2442, or through Bourgoyne, Kathy via phone (843) 536-9888.

Contact Information

Primary practice address
461 W Cheves St Florence SC 29501-4446
Phone: (843) 601-2442
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bourgoyne, Kathy
Phone: (843) 536-9888

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1598400475
LBN Legal business name Riverside Pediatric Dentistry Llc
DBA Doing business as
Authorized official Bourgoyne, Kathy
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2022
Last updated May 4th, 2022 - 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 1598400475 NPPES
South Carolina MEDICAID ZX8488

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