| Pageland Dentistry Pa | |
|
124 S Pearl St Pageland SC 29728-2254 | |
| (843) 672-2403 | |
| (843) 672-3299 |
| Full Name | Pageland Dentistry Pa |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 124 S Pearl St, Pageland, South Carolina |
| Authorized Official Name and Position | Anastasia V Voronina (OWNER/DENTIST) |
| Authorized Official Contact | 8436722403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pageland Dentistry Pa 124 S Pearl St Pageland SC 29728-2254 Ph: (843) 672-2403 | Pageland Dentistry Pa 124 S Pearl St Pageland SC 29728-2254 Ph: (843) 672-2403 |
| NPI Number | 1689088676 |
|---|---|
| Provider Enumeration Date | 06/17/2014 |
| Last Update Date | 06/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689088676 | NPI | - | NPPES |
| ZX4435 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 4435 (South Carolina) | Primary |
Andrew Scott Jackson, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1303 South Pearl St, Pageland, SC 29728 Phone: 843-672-2444 | |
Thomas M. Hendley, D.m.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 S Pearl St, Pageland, SC 29728 Phone: 843-672-2403 Fax: 843-672-3299 |