Provider Demographics
NPI:1770769713
Name:VORONINA, ANASTASIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:
Last Name:VORONINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-2254
Mailing Address - Country:US
Mailing Address - Phone:843-672-2403
Mailing Address - Fax:843-672-3299
Practice Address - Street 1:124 S PEARL ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-2254
Practice Address - Country:US
Practice Address - Phone:843-672-2403
Practice Address - Fax:843-672-3299
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44351223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice