Provider Demographics
NPI:1386807220
Name:COST, RODNEY NICHOLAS II (DDS)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:NICHOLAS
Last Name:COST
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 W FARLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-3055
Mailing Address - Country:US
Mailing Address - Phone:864-984-7323
Mailing Address - Fax:
Practice Address - Street 1:318 W FARLEY AVE
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-3055
Practice Address - Country:US
Practice Address - Phone:864-984-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011137A122300000X
SCDGD 70821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist