MEDICARE: DR. WILLIAM P. MILLS JR. DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	2121	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699748095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM P. MILLS JR. DMD

Provider Business Mailing Address
First Line	:	280 NORTH GROVE MEDICAL PARK DRIVE
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4222
Country	:	US
Telephone Number	:	864-585-3318
Fax Number	:	864-585-4800

Provider Business Practice Location Address
First Line	:	280 NORTH GROVE MEDICAL PARK DRIVE
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-4222
Country	:	US
Telephone Number	:	864-585-3318
Fax Number	:	864-585-4800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	08/30/2010

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