| South Carolina Periodontology Pa | |
|
2120 N Beltline Boulevard Columbia SC 29204-3905 | |
| (803) 782-0528 | |
| (803) 782-1036 |
| Full Name | South Carolina Periodontology Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2120 N Beltline Boulevard, Columbia, South Carolina |
| Authorized Official Name and Position | William Cleveland James (OWNER) |
| Authorized Official Contact | 8037820528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Periodontology Pa 2120 N Beltline Boulevard Columbia SC 29204-3905 Ph: (803) 782-0528 | South Carolina Periodontology Pa 2120 N Beltline Boulevard Columbia SC 29204-3905 Ph: (803) 782-0528 |
| NPI Number | 1598856353 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598856353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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