Provider Demographics
NPI:1407048226
Name:YORK DENTAL TEAM, LLC
Entity Type:Organization
Organization Name:YORK DENTAL TEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-684-3827
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:333 E. LIBERTY STREET
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-0712
Mailing Address - Country:US
Mailing Address - Phone:803-684-3827
Mailing Address - Fax:803-684-9101
Practice Address - Street 1:333 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-1575
Practice Address - Country:US
Practice Address - Phone:803-684-3827
Practice Address - Fax:803-684-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental