Distinctive Dentistry in Irmo - General Practice
Distinctive Dentistry - NPI 1760664304
Distinctive Dentistry is a General Practice in Irmo, South Carolina. Distinctive Dentistry practices all healthcare services and medical treatments related to General Practice. The NPI Number for Distinctive Dentistry is 1760664304. The last update date is 2007-12-05.
Distinctive Dentistry's current location address is 11107 Broad River Rd, Irmo, South Carolina. You can contact this provider via phone number 8037493980 and fax number 8037493981. The mailing address for Distinctive Dentistry is 11107 Broad River Rd, Irmo, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Distinctive Dentistry |
|---|---|
| Address | 11107 Broad River Rd, Irmo, South Carolina |
| Phone Number | 8037493980 |
| Fax Number | 8037493981 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Cunningham Ray Robert |
| Credentials | DMD |
| Telephone Number | 8039176962 |
NPI Number Detail
| NPI Number | 1760664304 |
|---|---|
| Provider Enumeration Date | 2007-12-05 |
| Last Updated Date | 2007-12-05 |
Provider Mailing Address Detail
| Address | 11107 Broad River Rd |
|---|---|
| City | Irmo |
| State | South Carolina (SC) |
| Post Code | 290637602 |
| Phone Number | 8037493980 |
| Fax Number | 8037493981 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 4114 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identification code issued to Distinctive Dentistry by the Centers for Medicare & Medicaid Services?
The Distinctive Dentistry has been assigned the NPI (National Provider Identifier) 1760664304 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Distinctive Dentistry's facilities are geographically located?
The facilities of Distinctive Dentistry are physically situated at the following location: 11107 Broad River Rd, Irmo, SC, 290637602.
What is Distinctive Dentistry's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Distinctive Dentistry's specialized field of practice is General Practice, and the corresponding taxonomy code that categorizes this area of specialization is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services assign the 1760664304 to Distinctive Dentistry?
The Centers for Medicare & Medicaid Services assigned the 1760664304 to Distinctive Dentistry on 2007-12-05.
When was the information regarding Distinctive Dentistry most recently updated?
The details pertaining to the Distinctive Dentistry, including its address, specialty, and other relevant information, were last refreshed on 2007-12-05.