National Provider Identifier Database

EAU CLAIRE COOPERATIVE HEALTH CENTER INC
General Practice

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.


Contact Information

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
3800 N MAIN ST
STE. C
COLUMBIA, SC29203-6414
Phone: 803-705-3169
Fax: 803-705-3175
Website:
Specialty Taxonomy Code
* General Practice 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.

NPI Number 1457740789
Legal business name
LBN
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Authorized official DELGAOD CANTAVE - (CEO)
Entity Organization
Organization subpart No
Enumeration date 01/09/2015
Last updated 02/03/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • SC Medicaid: ZA9183

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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