| Lake Wylie Pediatric Dentistry, Llc | |
|
534 Nautical Dr. Clover SC 29710-6102 | |
| (803) 619-5155 | |
| Not Available |
| Full Name | Lake Wylie Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 534 Nautical Dr., Clover, South Carolina |
| Authorized Official Name and Position | Ryan Peter Colosi (MEMBER) |
| Authorized Official Contact | 8036195155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Wylie Pediatric Dentistry, Llc 534 Nautical Dr Lake Wylie SC 29710-5001 Ph: (803) 619-5155 | Lake Wylie Pediatric Dentistry, Llc 534 Nautical Dr. Clover SC 29710-6102 Ph: (803) 619-5155 |
| NPI Number | 1528428091 |
|---|---|
| Provider Enumeration Date | 02/26/2016 |
| Last Update Date | 03/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528428091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 8097 (South Carolina) | Primary |
Joseph H Hourihan Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Church St, Clover, SC 29710 Phone: 803-222-7711 | |
Jackson Clover Orthodontics Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1474 Highway 55 E Ste 100, Clover, SC 29710 Phone: 803-653-6979 | |
Clover Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Church St, Clover, SC 29710 Phone: 803-222-4518 Fax: 803-222-4598 | |
Modern Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3420 Filbert Hwy, Clover, SC 29710 Phone: 803-286-6455 | |
Dental Professionals Of South Carolina, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 Latitude Lane, Clover, SC 29710 Phone: 803-619-4511 Fax: 803-619-4586 |