| Sunset Periodontics, Llc | |
|
159 Medical Cir West Columbia SC 29169-3655 | |
| (803) 794-7520 | |
| Not Available |
| Full Name | Sunset Periodontics, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 159 Medical Cir, West Columbia, South Carolina |
| Authorized Official Name and Position | Travis Wayne Mize (OWNER) |
| Authorized Official Contact | 3173453113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunset Periodontics, Llc 159 Medical Cir West Columbia SC 29169-3655 Ph: (803) 794-7520 | Sunset Periodontics, Llc 159 Medical Cir West Columbia SC 29169-3655 Ph: (803) 794-7520 |
| NPI Number | 1598142341 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 06/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598142341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 826 (South Carolina) | Primary |
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