Provider Demographics
NPI:1548377799
Name:EDDY, H. NELSON (DDS PA)
Entity type:Individual
Prefix:DR
First Name:H.
Middle Name:NELSON
Last Name:EDDY
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 INDIA HOOK RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2783
Mailing Address - Country:US
Mailing Address - Phone:803-324-8141
Mailing Address - Fax:803-324-8115
Practice Address - Street 1:1144 INDIA HOOK RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2783
Practice Address - Country:US
Practice Address - Phone:803-324-8141
Practice Address - Fax:803-324-8115
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27931223P0300X
NC62201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics