Mcdonald Oral And Maxillofacial Surgery, Llc | |
1509 Heritage Ln Florence SC 29505-3141 | |
(843) 799-4878 | |
(843) 799-4977 |
Full Name | Mcdonald Oral And Maxillofacial Surgery, Llc |
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Speciality | Dentist |
Location | 1509 Heritage Ln, Florence, South Carolina |
Authorized Official Name and Position | Thomas Albert Mcdonald (OWNER) |
Authorized Official Contact | 8437994878 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mcdonald Oral And Maxillofacial Surgery, Llc 1509 Heritage Ln Florence SC 29505-3141 Ph: (843) 799-4878 | Mcdonald Oral And Maxillofacial Surgery, Llc 1509 Heritage Ln Florence SC 29505-3141 Ph: (843) 799-4878 |
NPI Number | 1538552625 |
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Provider Enumeration Date | 03/12/2015 |
Last Update Date | 01/25/2017 |
Medicare PECOS PAC ID | 7214240076 |
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Medicare Enrollment ID | O20150722005331 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538552625 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 3176 (South Carolina) | Primary |
Provider Name | Thomas A Mcdonald |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1932113180 PECOS PAC ID: 8527046721 Enrollment ID: I20111108000364 |
G. Thomas Bryce, Jr., Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1509 W Palmetto St, Florence, SC 29501 Phone: 843-662-8413 Fax: 843-662-2672 | |
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