| Carolina Periodontics & Dental Implants | |
|
112 W Broad St Unit 405 Greenville SC 29601-2688 | |
| (480) 289-0507 | |
| Not Available |
| Full Name | Carolina Periodontics & Dental Implants |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 112 W Broad St Unit 405, Greenville, South Carolina |
| Authorized Official Name and Position | Shawna Baxter (PERIODONTIST/OWNER) |
| Authorized Official Contact | 4802890507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Periodontics & Dental Implants 112 W Broad St Unit 405 Greenville SC 29601-2688 Ph: () - | Carolina Periodontics & Dental Implants 112 W Broad St Unit 405 Greenville SC 29601-2688 Ph: (480) 289-0507 |
| NPI Number | 1649725102 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 08/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649725102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 8638 (South Carolina) | Primary |
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