Provider Demographics
NPI:1265942544
Name:HARTSVILLE FAMILY DENTISTRY ASSOCIATES INC
Entity type:Organization
Organization Name:HARTSVILLE FAMILY DENTISTRY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-332-3781
Mailing Address - Street 1:935 W HOME AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4435
Mailing Address - Country:US
Mailing Address - Phone:843-332-3781
Mailing Address - Fax:843-332-9701
Practice Address - Street 1:935 W HOME AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4435
Practice Address - Country:US
Practice Address - Phone:843-332-3781
Practice Address - Fax:843-332-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC84031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty