Provider Demographics
NPI:1992030324
Name:NORTH AIKEN DENTAL LLC
Entity Type:Organization
Organization Name:NORTH AIKEN DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHEA
Authorized Official - Middle Name:G
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-649-9899
Mailing Address - Street 1:1466 COLUMBIA HWY N
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-8723
Mailing Address - Country:US
Mailing Address - Phone:803-649-9899
Mailing Address - Fax:803-649-9894
Practice Address - Street 1:1466 COLUMBIA HWY N
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-8723
Practice Address - Country:US
Practice Address - Phone:803-649-9899
Practice Address - Fax:803-649-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty