Pediatric Dentistry Of Greenville,P.A.

LBN: Pediatric Dentistry Of Greenville,P.A.
Pediatric Dentistry Of Greenville,P.A. is an health care organization with primary practice located at 410A Pelham Rd , Greenville SC 29615-3502. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Pediatric Dentistry Of Greenville,P.A. can be contacted via phone (864) 232-1574, or through Martinez, Kim via phone (864) 232-1574.

Contact Information

Primary practice address
410A Pelham Rd Greenville SC 29615-3502
Phone: (864) 232-1574
Fax: (864) 232-6800
Website:
Map and Directions
Authorized official contact:
Name: Martinez, Kim
Phone: (864) 232-1574

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X ZA9916 South Carolina

Profile Details

NPI number 1902884984
LBN Legal business name Pediatric Dentistry Of Greenville,P.A.
DBA Doing business as
Authorized official Martinez, Kim
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902884984 NPPES
South Carolina MEDICAID ZA9916

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