Lake Wylie Pediatric Dentistry, Llc is a Pediatric Dental Clinic in Clover, South Carolina. It is located at 534 Nautical Dr., Clover, SC and its contact number is 803-619-5155. The authorized person for Lake Wylie Pediatric Dentistry, Llc is Ryan Peter Colosi
who is Member of the clinic and their contact number is 803-619-5155. The primary license number for Lake Wylie Pediatric Dentistry, Llc is 8097 (Pediatric Dentistry) in South Carolina.
Lake Wylie Pediatric Dentistry, Llc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Lake Wylie Pediatric Dentistry, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Lake Wylie Pediatric Dentistry, Llc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 534 Nautical Dr., Clover,
South Carolina, 29710-6102 |
| Phone: | 803-619-5155 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Ryan Peter Colosi |
| Position: | Member |
| Contact Number: | 803-619-5155 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Lake Wylie Pediatric Dentistry, Llc clinic are as mentioned below.
| NPI Number: | 1528428091 |
| NPI Enumeration Date: | 26 Feb, 2016 |
| NPI Last Update On: | 24 Mar, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Lake Wylie Pediatric Dentistry, Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 8097 | South Carolina | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Lake Wylie Pediatric Dentistry, Llc
534 Nautical Dr,
Lake Wylie, South Carolina |
| Zip: | 29710-5001 |
| Phone Number: | 803-619-5155 |
Patients can reach Lake Wylie Pediatric Dentistry, Llc at
534 Nautical Dr., Clover, South Carolina or can
call to book an appointment on 803-619-5155.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.