Azalea Dental Llc

LBN: Azalea Dental Llc
Azalea Dental Llc is an health care organization with primary practice located at 310 N Gum St Ste B , Summerville SC 29483-6874. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Azalea Dental Llc can be contacted via phone (843) 216-9754, or through Riley, Thomas Patrick via phone (843) 261-9754.

Contact Information

Primary practice address
310 N Gum St Ste B Summerville SC 29483-6874
Phone: (843) 216-9754
Fax: (843) 216-9756
Website:
Map and Directions
Authorized official contact:
Name: Riley, Thomas Patrick Doctor of Dental Medicine (DMD)
Phone: (843) 261-9754

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3580 South Carolina

Profile Details

NPI number 1568678407
LBN Legal business name Azalea Dental Llc
DBA Doing business as
Authorized official Riley, Thomas Patrick Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2007
Last updated Jul 17th, 2007 - about 19 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 1568678407 NPPES
South Carolina MEDICAID ZX03580

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