| Mundo Management | |
|
3463 Highway 21 Byp Ste 1 Fort Mill SC 29715-7245 | |
| (704) 825-2081 | |
| (803) 335-5189 |
| Full Name | Mundo Management |
|---|---|
| Speciality | Dentist |
| Location | 3463 Highway 21 Byp Ste 1, Fort Mill, South Carolina |
| Authorized Official Name and Position | Blake Carson Kingsbury (DR. BLAKE KINGSBURY, D.M.D) |
| Authorized Official Contact | 7048252081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mundo Management 3463 Highway 21 Byp Ste 1 Fort Mill SC 29715-7245 Ph: (704) 825-2081 | Mundo Management 3463 Highway 21 Byp Ste 1 Fort Mill SC 29715-7245 Ph: (704) 825-2081 |
| NPI Number | 1922480060 |
|---|---|
| Provider Enumeration Date | 06/25/2015 |
| Last Update Date | 06/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922480060 | NPI | - | NPPES |
| 1831338276 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8552 (South Carolina) | Primary |
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