<Unavail>

LBN: Park Dental Group, Llc
<Unavail> is an health care organization with primary practice located at 1578 Constitution Blvd Ste 01, Rock Hill SC 29732-3543. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Park Dental Group, Llc can be contacted via phone (803) 366-1456, or through Park, Jae Sung via phone (803) 366-1456.

Contact Information

Primary practice address
1578 Constitution Blvd Ste 01 Rock Hill SC 29732-3543
Phone: (803) 366-1456
Fax: (803) 324-0117
Website:
Map and Directions
Authorized official contact:
Name: Park, Jae Sung
Phone: (803) 366-1456

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8288 South Carolina

Profile Details

NPI number 1275908923
LBN Legal business name Park Dental Group, Llc
DBA Doing business as <Unavail>
Authorized official Park, Jae Sung
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2015
Last updated Dec 7th, 2015 - about 11 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 1275908923 NPPES
South Carolina MEDICAID ZX8288

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