| Orthodontic Care Of Carolina, Pa | |
|
1415 Pine Street Columbia SC 29204 | |
| (704) 509-4999 | |
| (704) 509-4961 |
| Full Name | Orthodontic Care Of Carolina, Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1415 Pine Street, Columbia, South Carolina |
| Authorized Official Name and Position | Ford Sawyer Cooper (OWNER) |
| Authorized Official Contact | 7045094999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthodontic Care Of Carolina, Pa 3010 Baucom Rd Suite 100 Charlotte NC 28269 Ph: (704) 509-4999 | Orthodontic Care Of Carolina, Pa 1415 Pine Street Columbia SC 29204 Ph: (704) 509-4999 |
| NPI Number | 1447509492 |
|---|---|
| Provider Enumeration Date | 09/06/2012 |
| Last Update Date | 12/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447509492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3205 (South Carolina) | Primary |
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