| Diane Jenkins Periodontics, Llc | |
|
110a Hospital Dr Simpsonville SC 29681-3226 | |
| (864) 757-8820 | |
| (864) 282-1955 |
| Full Name | Diane Jenkins Periodontics, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 110a Hospital Dr, Simpsonville, South Carolina |
| Authorized Official Name and Position | Beth Illsley (DIRECTOR OF INSURANCE) |
| Authorized Official Contact | 8642821935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Jenkins Periodontics, Llc 400 Memorial Drive Ext Ste 400 Greer SC 29651-1850 Ph: (864) 282-1935 | Diane Jenkins Periodontics, Llc 110a Hospital Dr Simpsonville SC 29681-3226 Ph: (864) 757-8820 |
| NPI Number | 1043699770 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 01/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043699770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 7146/788 (South Carolina) | Primary |
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