Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Wylie Pediatric Dentistry, LLC

Organization Pediatric Dentistry · NPI 1528428091

Lake Wylie Pediatric Dentistry, LLC is a Pediatric Dentistry in Clover, South Carolina. Licensed in South Carolina. Registered with an NPI since 2016.

Licensed in
SC
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

534 Nautical Dr
Clover, SC 29710-6102
Phone: (803) 619-5155
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 8097 (SC)

Record details

NPI number1528428091
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Colosi — Member · (803) 619-5155
Other names Ryan P Colosi Dds
NPI enumeratedFebruary 26, 2016
Last updated in NPPESMarch 24, 2017
Mailing address534 Nautical Dr, Lake Wylie, SC 29710-5001