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General NPI Number Information
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NPI Number | 1003034026
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Entity Type | Organization
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Legal Business Name | WORLD CLASS DENTISTRY, INC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | BYPASS 123 SUITE 302
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City | SENECA
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State | SC
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Zip | 29678
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Country | US
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Telephone | 864-888-0020
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Fax | 864-885-1981
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Provider Business Mailing Address
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Address Line | BYPASS 123 SUITE 302
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City | SENECA
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State | SC
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Zip | 29678
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Country | US
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Telephone | 864-888-0020
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Fax | 864-885-1981
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDY JOHNSON
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Credential | D.M.D.
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Telephone | 864-888-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3056
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License Number State | SC
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