| Royal Crest Centre For Advanced Dentistry | |
|
104 Montgomery Dr Anderson SC 29621-3334 | |
| (864) 225-3763 | |
| (864) 225-8486 |
| Full Name | Royal Crest Centre For Advanced Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 104 Montgomery Dr, Anderson, South Carolina |
| Authorized Official Name and Position | Patrick Ryan Marcello (OWNER) |
| Authorized Official Contact | 8642253763 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Royal Crest Centre For Advanced Dentistry 104 Montgomery Dr Anderson SC 29621-3334 Ph: (864) 225-3763 | Royal Crest Centre For Advanced Dentistry 104 Montgomery Dr Anderson SC 29621-3334 Ph: (864) 225-3763 |
| NPI Number | 1609922517 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 12/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609922517 | NPI | - | NPPES |
| ZA9525 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3609 (South Carolina) | Primary |
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