Liberty Dental Care, Inc. | |
207 W Front St Liberty SC 29657-1009 | |
(864) 843-3742 | |
(864) 843-3744 |
Full Name | Liberty Dental Care, Inc. |
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Speciality | Clinic/center - Dental |
Location | 207 W Front St, Liberty, South Carolina |
Authorized Official Name and Position | James L Wilson (GENERAL DENTIST) |
Authorized Official Contact | 8648433742 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Liberty Dental Care, Inc. 207 W Front St Liberty SC 29657-1009 Ph: (864) 843-3742 | Liberty Dental Care, Inc. 207 W Front St Liberty SC 29657-1009 Ph: (864) 843-3742 |
NPI Number | 1932376035 |
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Provider Enumeration Date | 05/08/2008 |
Last Update Date | 05/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932376035 | NPI | - | NPPES |
Z31449 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 3144 (South Carolina) | Primary |
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