UPSTATE PEDIATRIC DENTISTRY PA NPI 1275780454

NPI Information

UPSTATE PEDIATRIC DENTISTRY, PA is a pediatric dentistry dentist in Greenville, SC. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. UPSTATE PEDIATRIC DENTISTRY, PA NPI is 1275780454. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105-A HALTON ROAD
GREENVILLE, SC
ZIP 29607-507
Phone: (864) 676-9873
Fax: (864) 676-9870

The provider's authorized official is Brian Timothy Jones .
The authorized official title is Dentist and has the following contact phone number (864) 676-9873.

The enumeration date for this NPI number is 8/19/2008 and was last updated on 8/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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