| Wood Creek Dental Pa | |
|
2101 Pelham Road Granville SC 29615 | |
| (864) 288-5300 | |
| (864) 288-9430 |
| Full Name | Wood Creek Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 2101 Pelham Road, Granville, South Carolina |
| Authorized Official Name and Position | Dale Edison Hunt (PRESIDENT) |
| Authorized Official Contact | 8642885300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wood Creek Dental Pa Po Box 25604 2101 Pelham Road Granville SC 29615 Ph: (864) 288-5300 | Wood Creek Dental Pa 2101 Pelham Road Granville SC 29615 Ph: (864) 288-5300 |
| NPI Number | 1265440242 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265440242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3913 (South Carolina) | Secondary |
| 122300000X | Dentist | 4194 (South Carolina) | Secondary |
| 122300000X | Dentist | 2234 (South Carolina) | Primary |