| Southern Oak Dental, Llc | |
|
2127 E Main St Spartanburg SC 29307-1454 | |
| (864) 216-7390 | |
| Not Available |
| Full Name | Southern Oak Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2127 E Main St, Spartanburg, South Carolina |
| Authorized Official Name and Position | Frank Gong (OWNER) |
| Authorized Official Contact | 2063712940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oak Dental, Llc 4921 Centre Pointe Dr Ste 201 N Charleston SC 29418-6997 Ph: (843) 459-8780 | Southern Oak Dental, Llc 2127 E Main St Spartanburg SC 29307-1454 Ph: (864) 216-7390 |
| NPI Number | 1427510767 |
|---|---|
| Provider Enumeration Date | 04/04/2019 |
| Last Update Date | 01/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427510767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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