NPI 1417309451 · live from the CMS NPI Registry
Ashby Park Pediatric Dentistry Easley
Dentist, Pediatric Dentistry in Easley, SC. National Provider Identifier 1417309451, active.
NPI record
| NPI | 1417309451 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Pediatric Dentistry 1223P0221X |
| Practice location | 708 North A Street, Easley, SC 29640 |
| Practice phone | 864-605-7741 |
| Enumerated | July 1, 2016 |
| Last updated | July 1, 2016 |
| Authorized official | Jennifer Garvey, Partner/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | 3638 (SC) |
| Dentist, Pediatric Dentistry primary | 1223P0221X | 3638 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.