| Foothills Oral & Facial Surgery, Pa | |
|
634 Fairview Rd Building C Simpsonville SC 29680 | |
| (864) 967-4000 | |
| Not Available |
| Full Name | Foothills Oral & Facial Surgery, Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 634 Fairview Rd, Simpsonville, South Carolina |
| Authorized Official Name and Position | Victor Lebedovych (PRESIDENT) |
| Authorized Official Contact | 8649674000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Oral & Facial Surgery, Pa 634 Fairview Rd Building C Simpsonville SC 29680 Ph: (864) 967-4000 | Foothills Oral & Facial Surgery, Pa 634 Fairview Rd Building C Simpsonville SC 29680 Ph: (864) 967-4000 |
| NPI Number | 1104974609 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104974609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4084 (South Carolina) | Primary |
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