| Hall Street Family Dental | |
|
162 Hall St Spartanburg SC 29302-1524 | |
| (864) 582-5915 | |
| (864) 582-1076 |
| Full Name | Hall Street Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 162 Hall St, Spartanburg, South Carolina |
| Authorized Official Name and Position | Jenni Tomlinson (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8645825915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hall Street Family Dental 162 Hall St Spartanburg SC 29302-1524 Ph: (864) 582-5915 | Hall Street Family Dental 162 Hall St Spartanburg SC 29302-1524 Ph: (864) 582-5915 |
| NPI Number | 1720246325 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 03/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720246325 | NPI | - | NPPES |
| ZA9703 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | 2881 (South Carolina) | Secondary |
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