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General NPI Number Information
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NPI Number | 1801229224
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE DENTAL OF GREENWOOD
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 301 MONTAGUE AVE
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City | GREENWOOD
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State | SC
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Zip | 29649-1939
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Country | US
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Telephone | 864-229-7092
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Fax | 864-223-1083
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Provider Business Mailing Address
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Address Line | 301 MONTAGUE AVE
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City | GREENWOOD
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State | SC
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Zip | 29649-1939
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Country | US
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Telephone | 864-229-7092
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Fax | 864-223-1083
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DEBBIE M MOSS
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Credential |
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Telephone | 864-229-7092
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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 | 10059
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License Number State | SC
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