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Contact Information

KOOL SMILES SC-2, PC
1350 GROVE PARK DR
ORANGEBURG, SC29115-2455
 Phone: 770-916-9000
 Fax:
 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 KOOL SMILES SC-2, PC

NPI Number 1063708410
LBN Legal business name KOOL SMILES SC-2, PC
Authorized official DAVID VIETH - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/23/2011
Last updated 11/04/2014 - About 12 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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