| Prime Dental Of Woodruff | |
|
420 S Main St Woodruff SC 29388-2117 | |
| (864) 476-3212 | |
| (864) 476-3212 |
| Full Name | Prime Dental Of Woodruff |
|---|---|
| Speciality | Dentist |
| Location | 420 S Main St, Woodruff, South Carolina |
| Authorized Official Name and Position | Asa Duncan Shirley (OWNER) |
| Authorized Official Contact | 8648348001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental Of Woodruff 420 S Main St Woodruff SC 29388-2117 Ph: (864) 476-3212 | Prime Dental Of Woodruff 420 S Main St Woodruff SC 29388-2117 Ph: (864) 476-3212 |
| NPI Number | 1407918014 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407918014 | NPI | - | NPPES |
| ZA9487 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1863 (South Carolina) | Primary |
Woodruff Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 E Georgia St, Woodruff, SC 29388 Phone: 864-476-8315 | |
Progrin Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 S Main St, Woodruff, SC 29388 Phone: 864-834-8001 Fax: 864-476-0439 |