| Foothills Oral & Facial Surgery | |
|
301 W Beltline Blvd #301 Anderson SC 29625-1505 | |
| (864) 967-4000 | |
| (864) 328-9907 |
| Full Name | Foothills Oral & Facial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 301 W Beltline Blvd, Anderson, South Carolina |
| Authorized Official Name and Position | Victor P Lebedovych (PRESIDENT/CEO) |
| Authorized Official Contact | 8649674000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Oral & Facial Surgery 301 W Beltline Blvd #301 Anderson SC 29625-1505 Ph: (864) 967-4000 | Foothills Oral & Facial Surgery 301 W Beltline Blvd #301 Anderson SC 29625-1505 Ph: (864) 967-4000 |
| NPI Number | 1134549629 |
|---|---|
| Provider Enumeration Date | 04/23/2014 |
| Last Update Date | 04/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134549629 | NPI | - | NPPES |
| 1223S0112X | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4084 (South Carolina) | Primary |
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