| Greenville Oral Surgery, P.a. | |
|
3929 S Highway 14 Greenville SC 29615-6138 | |
| (864) 281-9119 | |
| (864) 281-9776 |
| Full Name | Greenville Oral Surgery, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 3929 S Highway 14, Greenville, South Carolina |
| Authorized Official Name and Position | James C Wilson (PRESIDENT) |
| Authorized Official Contact | 8642819119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenville Oral Surgery, P.a. 3929 S Highway 14 Greenville SC 29615-6138 Ph: (864) 281-9119 | Greenville Oral Surgery, P.a. 3929 S Highway 14 Greenville SC 29615-6138 Ph: (864) 281-9119 |
| NPI Number | 1619008547 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619008547 | NPI | - | NPPES |
| Z 31948 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 30-03194 (South Carolina) | Primary |
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