Provider Demographics
NPI:1235346511
Name:ADVANCED FAMILY DENTISTRY
Entity Type:Organization
Organization Name:ADVANCED FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAWSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BITAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-850-9045
Mailing Address - Street 1:770 SACO LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3880
Mailing Address - Country:US
Mailing Address - Phone:864-850-9045
Mailing Address - Fax:864-850-0174
Practice Address - Street 1:770 SACO LOWELL RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3880
Practice Address - Country:US
Practice Address - Phone:864-850-9045
Practice Address - Fax:864-850-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3478122300000X
SC3293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty