| 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 |