Willoughby Dental Pa

NPI 1518241710 - Clinic/Center - 261QD0000X

NPI Details
NPI 1518241710
Enumeration Date 10/06/2011
Last Updated 10/06/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name MATTHEW SCOTT MATTHEW
Position OWNER/DENTIST
Phone (864) 546-4242
Fax
Practice Location
3101 S. HWY 14
SUITE 4
GREENVILLE SC, 29615, US
Phone (864) 546-4242
Fax
Business Location
3101 S. HWY 14
SUITE 4
GREENVILLE SC, 29615, US
Phone (864) 546-4242
Fax
Toxanomy
Taxonomy Code 261QD0000X
License State South Carolina
License Number 4579
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According to our database, Willoughby Dental Pa NPI is 1518241710, taxonomy code is 261QD0000X and license number is 4579, license state is located at South Carolina. Willoughby Dental Pa physically located at 3101 S. Hwy 14, Greenville SC, 29615. NPI Number 1033115704 has the healthcare provider type.

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1518241710 NPI number is provided on an as is basis without warranty of any kind. 1518241710 is maintained by the National Plan & Provider Enumeration System. The contents of Willoughby Dental Pa are for informational purposes only.