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General NPI Number Information
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NPI Number | 1518129493
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Entity Type | Organization
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Legal Business Name | PIEDMONT DENTAL CENTER -GREENWOOD, P.C.
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 1431 BYPASS 72 NE
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City | GREENWOOD
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State | SC
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Zip | 29649-2210
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Country | US
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Telephone | 864-223-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 BYPASS 72 NE
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City | GREENWOOD
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State | SC
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Zip | 29649-2210
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Country | US
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Telephone | 864-223-5373
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Fax |
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Authorized Official
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Title or Position | DMD
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Name | TERRY BROWN
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Credential |
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Telephone | 864-223-5373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4470
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License Number State | SC
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