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Contact Information

CRESTON DENTAL-1, P.C.
3112 N MAIN ST
ANDERSON, SC29621-2763
 Phone: 678-904-5665
 Fax: 678-904-5669
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for CRESTON DENTAL 1 PC · (Female)

NPI Number 1972687903
Status Active
Credentials
Entity Individual
Enumeration date 10/25/2006
Last updated 05/13/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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