| Sea Glass Periodontics Of Simpsonville Llc | |
|
110a Hospital Dr Simpsonville SC 29681-3226 | |
| (864) 757-8820 | |
| (864) 751-6387 |
| Full Name | Sea Glass Periodontics Of Simpsonville 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 |
|---|---|
| Sea Glass Periodontics Of Simpsonville Llc 400 Memorial Drive Ext Ste 400 Greer SC 29651-1850 Ph: (864) 282-1935 | Sea Glass Periodontics Of Simpsonville Llc 110a Hospital Dr Simpsonville SC 29681-3226 Ph: (864) 757-8820 |
| NPI Number | 1295344646 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 07/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295344646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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