| C Fred Marcinak Dmd Pa | |
|
102 Lusk Drive West Union SC 29696 | |
| (864) 638-7228 | |
| (864) 718-7162 |
| Full Name | C Fred Marcinak Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 102 Lusk Drive, West Union, South Carolina |
| Authorized Official Name and Position | C Fred Marcinak (DENTIST PRESIDENT) |
| Authorized Official Contact | 8646387228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C Fred Marcinak Dmd Pa Po Box 648 Walhalla SC 29691 Ph: (864) 638-7228 | C Fred Marcinak Dmd Pa 102 Lusk Drive West Union SC 29696 Ph: (864) 638-7228 |
| NPI Number | 1164583183 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164583183 | NPI | - | NPPES |
| 002195 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2195 (South Carolina) | Primary |
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