| Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.a. | |
|
227 S Pendleton St Suite A Easley SC 29640-3047 | |
| (864) 855-0383 | |
| (864) 855-0390 |
| Full Name | Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 227 S Pendleton St, Easley, South Carolina |
| Authorized Official Name and Position | Samer Atallah Joudeh (OWNER) |
| Authorized Official Contact | 8648550383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.a. 227 S Pendleton St Suite A Easley SC 29640-3047 Ph: (864) 855-0383 | Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.a. 227 S Pendleton St Suite A Easley SC 29640-3047 Ph: (864) 855-0383 |
| NPI Number | 1770707887 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770707887 | NPI | - | NPPES |
| ZZ1503 | Medicaid | SC | |
| ZX3518 | Medicaid | SC | |
| 1730197641 | Other | SC | NPI SAMER A. JOUDEH |
| ZG1698 | Medicaid | SC | |
| 1629182506 | Other | SC | NPI W. MICHAEL RIDDLE |
| 1780769307 | Other | SC | NPI S. ANTHONY BOWIE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (South Carolina) | Primary |
Fleetwood Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 Fleetwood Dr, Easley, SC 29640 Phone: 864-855-2788 Fax: 864-855-2789 | |
Indigo Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1673 E Main St Unit B, Easley, SC 29640 Phone: 864-442-6770 Fax: 864-442-6830 | |
Holly Tree Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1673 E Main St, Easley, SC 29640 Phone: 864-442-6770 Fax: 864-442-6830 | |
Nasim & Kennemore Holdings, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 Powdersville Rd, Easley, SC 29642 Phone: 864-269-5290 | |
Advanced Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 770 Saco Lowell Rd, Easley, SC 29640 Phone: 864-850-9045 Fax: 864-850-0174 | |
Waters Orthodontics, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Franklin Square Way Ste A, Easley, SC 29642 Phone: 864-855-6360 Fax: 864-855-6361 | |
Dental Associates Of Easley, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 807 S Pendleton St, Easley, SC 29640 Phone: 864-859-0111 Fax: 864-859-0112 |