Carolina Dental Practice | |
219b North Mine Street Mccormick SC 29835 | |
(864) 852-2571 | |
(864) 852-2674 |
Full Name | Carolina Dental Practice |
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Speciality | Dentist |
Location | 219b North Mine Street, Mccormick, South Carolina |
Authorized Official Name and Position | Lisa Y Gilmer (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 8643960117 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Carolina Dental Practice 313 Main St Greenwood SC 29646-2757 Ph: (864) 852-2571 | Carolina Dental Practice 219b North Mine Street Mccormick SC 29835 Ph: (864) 852-2571 |
NPI Number | 1336272400 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336272400 | NPI | - | NPPES |
457941 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |