Provider Demographics
NPI:1316437627
Name:DAVID M LOVIT DMD - SDA LLC
Entity type:Organization
Organization Name:DAVID M LOVIT DMD - SDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-787-4900
Mailing Address - Street 1:3600 FOREST DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4057
Mailing Address - Country:US
Mailing Address - Phone:803-787-4900
Mailing Address - Fax:803-787-8150
Practice Address - Street 1:3600 FOREST DR STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4057
Practice Address - Country:US
Practice Address - Phone:803-787-4900
Practice Address - Fax:803-787-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty