| Regenesis Community Health Center Dental Office | |
|
550 S Church Street Unit 2 Spartanburg SC 29306-3306 | |
| (864) 582-2817 | |
| Not Available |
| Full Name | Regenesis Community Health Center Dental Office |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 550 S Church Street, Spartanburg, South Carolina |
| Authorized Official Name and Position | George Newby (CEO) |
| Authorized Official Contact | 8645822817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenesis Community Health Center Dental Office Po Box 5158 Spartanburg SC 29304-5158 Ph: (864) 582-2817 | Regenesis Community Health Center Dental Office 550 S Church Street Unit 2 Spartanburg SC 29306-3306 Ph: (864) 582-2817 |
| NPI Number | 1659609485 |
|---|---|
| Provider Enumeration Date | 12/07/2009 |
| Last Update Date | 06/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659609485 | NPI | - | NPPES |
| ZA9355 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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