Ravenel Periodontics, Pa | |
1130 E Butler Rd Greenville SC 29607-5908 | |
(864) 626-4777 | |
(864) 626-4779 |
Full Name | Ravenel Periodontics, Pa |
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Speciality | Dentist - Periodontics |
Location | 1130 E Butler Rd, Greenville, South Carolina |
Authorized Official Name and Position | Lisa Sherwood Ravenel (OWNER/DENTIST) |
Authorized Official Contact | 8646264777 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ravenel Periodontics, Pa Po Box 938 Mauldin SC 29662-0938 Ph: (864) 626-4777 | Ravenel Periodontics, Pa 1130 E Butler Rd Greenville SC 29607-5908 Ph: (864) 626-4777 |
NPI Number | 1013569771 |
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Provider Enumeration Date | 07/12/2019 |
Last Update Date | 07/12/2019 |
Identifier | Type | State | Issuer |
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1013569771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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