| 129 Plantation Groose Creek Professional, Llc | |
|
129 Plantation North Blvd Ste D Goose Creek SC 29445-5776 | |
| (843) 410-4920 | |
| (843) 410-4924 |
| Full Name | 129 Plantation Groose Creek Professional, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 129 Plantation North Blvd Ste D, Goose Creek, South Carolina |
| Authorized Official Name and Position | Peter Grumbos (OWNER) |
| Authorized Official Contact | 8434104920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 129 Plantation Groose Creek Professional, Llc 129 Plantation North Blvd Ste D Goose Creek SC 29445-5776 Ph: (843) 410-4920 | 129 Plantation Groose Creek Professional, Llc 129 Plantation North Blvd Ste D Goose Creek SC 29445-5776 Ph: (843) 410-4920 |
| NPI Number | 1487311296 |
|---|---|
| Provider Enumeration Date | 11/29/2021 |
| Last Update Date | 11/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487311296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
David L. Olson, Dmd, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Berkeley Square Ln, Pob 1460, Goose Creek, SC 29445 Phone: 843-553-5231 Fax: 843-797-7547 | |
Keith Bryan Flynn Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 St. James Ave., Goose Creek, SC 29445 Phone: 843-797-0782 Fax: 843-797-0954 | |
Dr. Keith B. Flynn Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1505 Red Bank Rd, Goose Creek, SC 29445 Phone: 843-824-8742 Fax: 843-824-8430 | |
Smiles At Goose Creek Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 St. James Ave, Goose Creek, SC 29445 Phone: 843-804-6927 | |
Brent R. Humphrey Dmd, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Springhall Dr, Goose Creek, SC 29445 Phone: 843-797-2000 Fax: 843-797-8826 | |
Cane Bay Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 597 Old Mount Holly Rd, Suite 205, Goose Creek, SC 29445 Phone: 843-797-7711 Fax: 843-797-7747 |