MEDICARE: ANDREW C OWINGS DMD PA

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	122300000X	Dentist	2376	SC

General Provider Information

NPI Number	:	1851420418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW C OWINGS DMD PA

Provider Business Mailing Address
First Line	:	321 N CAMBRIDGE STREET
Second Line	:
City	:	NINETY SIX
State	:	SC
Zip	:	29666-1012
Country	:	US
Telephone Number	:	864-543-4109
Fax Number	:	864-549-3246

Provider Business Practice Location Address
First Line	:	321 N CAMBRIDGE STREET
Second Line	:
City	:	NINETY SIX
State	:	SC
Zip	:	29666-1012
Country	:	US
Telephone Number	:	864-543-4109
Fax Number	:	864-549-3246

Authorized Official
Title or Position	:	DENTIST OWNER
Name	:	DR. ANDREW COLLIER OWINGS
Credential	:	DMD
Telephone Number	:	864-543-4109

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	01/14/2008

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