| Southern Oak Dental, Llc | |
|
1322 Broad St Unit 90 Sumter SC 29150-1984 | |
| (912) 856-9698 | |
| Not Available |
| Full Name | Southern Oak Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1322 Broad St Unit 90, Sumter, South Carolina |
| Authorized Official Name and Position | Frank Gong (OWNER) |
| Authorized Official Contact | 2063712516 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oak Dental, Llc 4921 Centre Pointe Dr Ste 201 North Charleston SC 29418-6997 Ph: (912) 856-9698 | Southern Oak Dental, Llc 1322 Broad St Unit 90 Sumter SC 29150-1984 Ph: (912) 856-9698 |
| NPI Number | 1336761097 |
|---|---|
| Provider Enumeration Date | 05/15/2020 |
| Last Update Date | 05/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336761097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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