Organization Name: | VICTORY DENTISTRY FOR KIDS |
NPI Number: | 1386030351 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TASHIA MCDONALD (MANAGER) |
Mailing Address: | 9787 Charlotte Hwy Ste 203 Indian Land |
State: | SC US |
Postal Code: | 297075511 |
Phone Number: | 8035472280 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2015 |
NPI Last Update Date: | 04/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305S00000X |
License Number: | 4382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Point of Service |
Taxonomy Specialization: | |
Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |