Lake Wylie Modern Dentistry

LBN: Lake Wylie Modern Dentistry, Pc
Lake Wylie Modern Dentistry is an health care organization with primary practice located at 140 Highway 274 , Lake Wylie SC 29710-6045. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Lake Wylie Modern Dentistry, Pc can be contacted via phone (803) 752-0565, or through Shahrestani, Ali via phone (803) 752-0565.

Contact Information

Primary practice address
140 Highway 274 Lake Wylie SC 29710-6045
Phone: (803) 752-0565
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Shahrestani, Ali Doctor of Dental Medicine (DMD)
Phone: (803) 752-0565

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X

Profile Details

NPI number 1194376491
LBN Legal business name Lake Wylie Modern Dentistry, Pc
DBA Doing business as Lake Wylie Modern Dentistry
Authorized official Shahrestani, Ali Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 27th, 2019
Last updated Jun 14th, 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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