Organization · Type 2 NPI

Greenville Pediatric Dentistry PA

Pediatric Dentistry · Greenville, SC

NPI number 1366522922 Active

Practice location

1376 Cleveland St
Greenville, SC 29607-2435

Fax (864) 250-1604

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

5 other providers at this address

Other pediatric dentistry providers in Greenville

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NPI record

NPI: 1366522922
Entity type: Organization (Type 2)
Issued: Oct 17, 2006
Last updated: Jun 10, 2010
Status: Active

Other names

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Drs. Wilson, Uprichard and Czarsty PA · former legal business name

Authorized official

Mrs. Tammy Knight Porter
Insurance Claims Manager
(864) 250-1100

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366522922

Greenville Pediatric Dentistry PA's National Provider Identifier is 1366522922, issued on Oct 17, 2006. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Greenville, SC. The record was last updated on Jun 10, 2010.