Provider Demographics
NPI:1629483425
Name:PAHEL, BHAVNA T (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:BHAVNA
Middle Name:T
Last Name:PAHEL
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-3547
Mailing Address - Country:US
Mailing Address - Phone:864-715-3200
Mailing Address - Fax:864-715-3201
Practice Address - Street 1:810 E MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-3547
Practice Address - Country:US
Practice Address - Phone:864-715-3200
Practice Address - Fax:864-715-3201
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9404122300000X
NC9806122300000X
SC10091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist