| Bella Vista Family Dental At Five Forks | |
|
2311 Woodruff Rd Simpsonville SC 29681-5442 | |
| (864) 501-9800 | |
| Not Available |
| Full Name | Bella Vista Family Dental At Five Forks |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2311 Woodruff Rd, Simpsonville, South Carolina |
| Authorized Official Name and Position | John Kennedy (OWNER) |
| Authorized Official Contact | 8645010070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Vista Family Dental At Five Forks Po Box 31625 Greenville SC 29608-1625 Ph: () - | Bella Vista Family Dental At Five Forks 2311 Woodruff Rd Simpsonville SC 29681-5442 Ph: (864) 501-9800 |
| NPI Number | 1073016937 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073016937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4377 (South Carolina) | Secondary |
| 1223G0001X | Dentist - General Practice | 4377 (South Carolina) | Primary |
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