| Mirror Lake Family Dentistry Pa | |
|
54a Pointe Cir Greenville SC 29615-3506 | |
| (864) 235-0175 | |
| Not Available |
| Full Name | Mirror Lake Family Dentistry Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 54a Pointe Cir, Greenville, South Carolina |
| Authorized Official Name and Position | William Phillip Swinderman (DENTIST) |
| Authorized Official Contact | 2162878921 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirror Lake Family Dentistry Pa 54a Pointe Cir Greenville SC 29615-3506 Ph: (864) 235-0175 | Mirror Lake Family Dentistry Pa 54a Pointe Cir Greenville SC 29615-3506 Ph: (864) 235-0175 |
| NPI Number | 1366861437 |
|---|---|
| Provider Enumeration Date | 04/15/2014 |
| Last Update Date | 04/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366861437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4499 (South Carolina) | Primary |
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