MEDICARE: KOOL SMILES P.C.

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	1223P0221X	Pediatric Dentistry	4543	SC
2	1223G0001X	General Practice Dentistry	4543	SC

General Provider Information

NPI Number	:	1235203886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOOL SMILES P.C.

Provider Business Mailing Address
First Line	:	PO BOX 67
Second Line	:
City	:	TAYLORS
State	:	SC
Zip	:	29687-0002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3227 W BLUE RIDGE DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-3905
Country	:	US
Telephone Number	:	510-290-4744
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANGELA C BLACK
Credential	:	DMD
Telephone Number	:	510-290-4744

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	10/21/2009

Similar Medicare Providers

1073513172 — MRS. JAVON A. MCKENZIE DDS
Practice Location Address:

3227 W BLUE RIDGE DR
GREENVILLE, SC
29611-3905

Practice Phone: 864-295-8888
Practice Fax: 864-295-1241

1871682328 — KOOL SMILES, PC
Practice Location Address:

3203 W BLUE RIDGE DR
GREENVILLE, SC
29611-3905

Practice Phone: 800-920-9947
Practice Fax: 678-904-5669

1306132618 — MIGLENA V STOIKOV DMD
Practice Location Address:

3227 W BLUE RIDGE DR
GREENVILLE, SC
29611-3905

Practice Phone: 864-295-8888
Practice Fax:

1699058750 — CHERYLE REILLY DMD
Practice Location Address:

3227 W BLUE RIDGE DR
GREENVILLE, SC
29611-3905

Practice Phone: 313-848-0679
Practice Fax:

1477671840 — DR. GLENDA P CRAWFORD DMD
Practice Location Address:

1131 RUTHERFORD RD
GREENVILLE, SC
29609-3905

Practice Phone: 864-271-9062
Practice Fax: 864-271-9067

1619191764 — CRAWFORD FAMILY & COSMETIC DENTISTRY
Practice Location Address:

1131 RUTHERFORD RD
GREENVILLE, SC
29609-3905

Practice Phone: 864-271-9062
Practice Fax: 864-271-9067

Directions to “KOOL SMILES P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.