| Renee G Shongo Dmd Pa | |
|
163 Medical Circle West Columbia SC 29169-3655 | |
| (803) 794-0905 | |
| (803) 794-5472 |
| Full Name | Renee G Shongo Dmd Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 163 Medical Circle, West Columbia, South Carolina |
| Authorized Official Name and Position | Renee G Shongo (DENTIST PRACTICE OWNER) |
| Authorized Official Contact | 8037940905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee G Shongo Dmd Pa 163 Medical Circle West Columbia SC 29169-3655 Ph: (803) 794-0905 | Renee G Shongo Dmd Pa 163 Medical Circle West Columbia SC 29169-3655 Ph: (803) 794-0905 |
| NPI Number | 1902908338 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 01/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902908338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2575 (South Carolina) | Primary |
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