| Prime Dental, P.c. | |
|
28 S Main St Travelers Rest SC 29690-1810 | |
| (864) 834-8001 | |
| (864) 834-5563 |
| Full Name | Prime Dental, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 28 S Main St, Travelers Rest, South Carolina |
| Authorized Official Name and Position | Asa Duncan Shirley (OWNER) |
| Authorized Official Contact | 8648648001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental, P.c. 28 S Main St P. O. Box 987 Travelers Rest SC 29690-1810 Ph: (864) 834-8001 | Prime Dental, P.c. 28 S Main St Travelers Rest SC 29690-1810 Ph: (864) 834-8001 |
| NPI Number | 1891856209 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891856209 | NPI | - | NPPES |
| ZA9532 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1863 (South Carolina) | Primary |
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