Foothills Oral & Facial Surgery, Pa

NPI 1104974609 - Dentist - 1223S0112X

NPI Details
NPI 1104974609
Enumeration Date 01/08/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name VICTOR VICTOR
Position PRESIDENT
Phone (864) 967-4000
Fax
Practice Location
634 FAIRVIEW RD
BUILDING C
SIMPSONVILLE SC, 29680, US
Phone (864) 967-4000
Fax
Business Location
634 FAIRVIEW RD
BUILDING C
SIMPSONVILLE SC, 29680, US
Phone (864) 967-4000
Fax
Toxanomy
Taxonomy Code 1223S0112X
License State South Carolina
License Number 4084
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According to our database, Foothills Oral & Facial Surgery, Pa NPI is 1104974609, taxonomy code is 1223S0112X and license number is 4084, license state is located at South Carolina. Foothills Oral & Facial Surgery, Pa physically located at 634 Fairview Rd, Simpsonville SC, 29680. NPI Number 1033115704 has the healthcare provider type.

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1104974609 NPI number is provided on an as is basis without warranty of any kind. 1104974609 is maintained by the National Plan & Provider Enumeration System. The contents of Foothills Oral & Facial Surgery, Pa are for informational purposes only.