MEDICARE: DR. MARY G METROPOL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3003	SC

General Provider Information

NPI Number	:	1073642781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY G METROPOL DMD

Provider Business Mailing Address
First Line	:	1700 HENDERSON ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201
Country	:	US
Telephone Number	:	803-779-2633
Fax Number	:	803-779-2699

Provider Business Practice Location Address
First Line	:	1700 HENDERSON ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201
Country	:	US
Telephone Number	:	803-779-2633
Fax Number	:	803-779-2699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	03/18/2026

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