| Issaqueena Pediatric Dentistry P.a. | |
|
314 Union Station Dr Seneca SC 29678-4547 | |
| (864) 482-7900 | |
| (864) 482-7510 |
| Full Name | Issaqueena Pediatric Dentistry P.a. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 314 Union Station Dr, Seneca, South Carolina |
| Authorized Official Name and Position | Camille W Horton (PRESIDENT) |
| Authorized Official Contact | 8644827900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Issaqueena Pediatric Dentistry P.a. 314 Union Station Dr Seneca SC 29678-4547 Ph: (864) 482-7900 | Issaqueena Pediatric Dentistry P.a. 314 Union Station Dr Seneca SC 29678-4547 Ph: (864) 482-7900 |
| NPI Number | 1992056378 |
|---|---|
| Provider Enumeration Date | 09/26/2012 |
| Last Update Date | 09/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992056378 | NPI | - | NPPES |
| 1588875934 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4211 (South Carolina) | Primary |
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