| Simpsonville Dental Associates Pa | |
|
315 W Georgia Rd Simpsonville SC 29681-2401 | |
| (864) 963-3601 | |
| (864) 963-2598 |
| Full Name | Simpsonville Dental Associates Pa |
|---|---|
| Speciality | Dentist |
| Location | 315 W Georgia Rd, Simpsonville, South Carolina |
| Authorized Official Name and Position | Brooks A Godwin (DOCTOR PARTNER) |
| Authorized Official Contact | 8649633601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simpsonville Dental Associates Pa Po Box 799 Simpsonville SC 29681-0799 Ph: (864) 963-3601 | Simpsonville Dental Associates Pa 315 W Georgia Rd Simpsonville SC 29681-2401 Ph: (864) 963-3601 |
| NPI Number | 1407847213 |
|---|---|
| Provider Enumeration Date | 11/01/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3173993466 |
|---|---|
| Medicare Enrollment ID | O20230103000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407847213 | NPI | - | NPPES |
| 1363835 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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