MEDICAID DENTAL PRACTICE OF EASLEY, SC, INC

EASLEY, SC
NPI1932399862
Entity TypeOrganization
Authorized ContactSHAWN C EDWARDS
President
864-859-0111
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: SC  3944)
Enumeration Date2007-07-26
Last Update Date2007-07-26
Business Address
MEDICAID DENTAL PRACTICE OF EASLEY, SC, INC
807 S PENDLETON ST
EASLEY, SC 29640-3527
Phone number: 864-855-6530
Mailing Address
MEDICAID DENTAL PRACTICE OF EASLEY, SC, INC
415 S PENDLETON ST
EASLEY, SC 29640-3072
Phone number: 864-859-0111