| Dental Professionals Of South Carolina, P.c. | |
| 213 Main Street Blythewood SC 29016-0589 | |
| (803) 754-9545 | |
| (803) 754-2158 | 
| Full Name | Dental Professionals Of South Carolina, P.c. | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 213 Main Street, Blythewood, South Carolina | 
| Authorized Official Name and Position | Kim Wilson (CREDENTIALING COORDINATOR) | 
| Authorized Official Contact | 2175405170 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dental Professionals Of South Carolina, P.c. Po Box 589 Blythewood SC 29016-0589 Ph: (803) 754-9545 | Dental Professionals Of South Carolina, P.c. 213 Main Street Blythewood SC 29016-0589 Ph: (803) 754-9545 | 
| NPI Number | 1730455965 | 
|---|---|
| Provider Enumeration Date | 04/02/2012 | 
| Last Update Date | 04/02/2012 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730455965 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
| Nina H. Jones Dds, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 745 University Village Dr, Blythewood, SC 29016 Phone: 803-754-9160 Fax: 803-754-9162 | |
| John C Cosby Jr Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 745 University Village Drive, Blythewood, SC 29016 Phone: 803-754-9160 Fax: 803-754-9162 |