Provider Demographics
NPI:1699596429
Name:COMPREHENSIVE DENTAL SERVICES LLC
Entity type:Organization
Organization Name:COMPREHENSIVE DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRIYENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-858-6175
Mailing Address - Street 1:434 N DUNCAN BYP
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-8604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:434 N DUNCAN BYP
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-8604
Practice Address - Country:US
Practice Address - Phone:864-427-9721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty