Provider Demographics
NPI:1588967624
Name:FLORENCE FAMILY DENTAL CARE PA
Entity type:Organization
Organization Name:FLORENCE FAMILY DENTAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-662-1761
Mailing Address - Street 1:1840 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6121
Mailing Address - Country:US
Mailing Address - Phone:843-662-1761
Mailing Address - Fax:843-662-2740
Practice Address - Street 1:1840 2ND LOOP RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6121
Practice Address - Country:US
Practice Address - Phone:843-662-1761
Practice Address - Fax:843-662-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty