| Organization Name: | HOLLY TREE FAMILY DENTAL, PA |
| NPI Number: | 1083008890 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN MARIE BYNUM (OWNER, VP, SEC) |
| Mailing Address: | 1334 Highway 14 Simpsonville |
| State: | SC US |
| Postal Code: | 296815659 |
| Phone Number: | 8642975585 |
| Fax Number: | 8642974166 |
| NPI Enumeration Date: | 03/19/2015 |
| NPI Last Update Date: | 03/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 3427 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |