| Clarendon Smiles For A Lifetime | |
|
16 Weinberg St Manning SC 29102-2629 | |
| (803) 435-9555 | |
| (803) 435-9157 |
| Full Name | Clarendon Smiles For A Lifetime |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16 Weinberg St, Manning, South Carolina |
| Authorized Official Name and Position | Georgia Bennett Famuliner (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 8035844803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarendon Smiles For A Lifetime 16 Weinberg St Manning SC 29102-2629 Ph: (803) 435-9555 | Clarendon Smiles For A Lifetime 16 Weinberg St Manning SC 29102-2629 Ph: (803) 435-9555 |
| NPI Number | 1619058591 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 09/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619058591 | NPI | - | NPPES |
| ZA9561 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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