Provider Demographics
NPI:1316373244
Name:RICE CREEK PEDIATRIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:RICE CREEK PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-788-2676
Mailing Address - Street 1:2000 CLEMSON RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9538
Mailing Address - Country:US
Mailing Address - Phone:803-788-2676
Mailing Address - Fax:803-788-2675
Practice Address - Street 1:2000 CLEMSON RD
Practice Address - Street 2:SUITE 15
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-9538
Practice Address - Country:US
Practice Address - Phone:803-788-2676
Practice Address - Fax:803-788-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty