Provider Demographics
NPI:1699183699
Name:FOSTER ORTHODONTICS
Entity Type:Organization
Organization Name:FOSTER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LANG
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-933-4410
Mailing Address - Street 1:408 S DUNCAN BYP
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-7225
Mailing Address - Country:US
Mailing Address - Phone:864-427-2265
Mailing Address - Fax:
Practice Address - Street 1:408 S DUNCAN BYP
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-7225
Practice Address - Country:US
Practice Address - Phone:864-427-2265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty