Sandy Springs Dental Clinic | |
5302 Hwy 76 Pendleton SC 29677-9139 | |
(864) 261-3436 | |
Not Available |
Full Name | Sandy Springs Dental Clinic |
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Speciality | Dentist |
Location | 5302 Hwy 76, Pendleton, South Carolina |
Authorized Official Name and Position | Julie Cecelia Marzolf (VICE PRESIDENT) |
Authorized Official Contact | 8642613436 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sandy Springs Dental Clinic 5302 Highway 76 Pendleton SC 29670-9139 Ph: (864) 261-3436 | Sandy Springs Dental Clinic 5302 Hwy 76 Pendleton SC 29677-9139 Ph: (864) 261-3436 |
NPI Number | 1871794628 |
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Provider Enumeration Date | 05/30/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 6507174109 |
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Medicare Enrollment ID | O20160628000928 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871794628 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 2744 (South Carolina) | Primary |
Provider Name | Greg A Marzolf |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1265578371 PECOS PAC ID: 2860712841 Enrollment ID: I20160726002064 |
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