Provider Demographics
NPI:1568299840
Name:MCCONNELL, ERIN (RDH)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 RIVERFRONT LN
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4342
Mailing Address - Country:US
Mailing Address - Phone:864-346-6704
Mailing Address - Fax:
Practice Address - Street 1:2089 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5940
Practice Address - Country:US
Practice Address - Phone:864-288-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3817124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist