Provider Demographics
NPI:1891172508
Name:PRICE FAMILY AND COSMETIC DENTISTRY, INC
Entity type:Organization
Organization Name:PRICE FAMILY AND COSMETIC DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTISIT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-479-0721
Mailing Address - Street 1:565 CORLEY MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-0000
Mailing Address - Country:US
Mailing Address - Phone:803-479-0721
Mailing Address - Fax:803-461-8769
Practice Address - Street 1:565 CORLEY MILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-0000
Practice Address - Country:US
Practice Address - Phone:803-479-0721
Practice Address - Fax:803-461-8769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1234561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty