DIANE JENKINS PERIODONTICS OF CONGAREE LLC NPI 1568084408

NPI Information

DIANE JENKINS PERIODONTICS OF CONGAREE, LLC is a periodontics dentist in Greenville, SC. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DIANE JENKINS PERIODONTICS OF CONGAREE, LLC NPI is 1568084408. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Diane Jenkins Periodontics Of Congaree Llc.

The provider's business location address is:

600 CONGAREE RD
GREENVILLE, SC
ZIP 29607-518
Phone: (864) 757-8820
Fax: (864) 751-6387

The provider's authorized official is Beth Illsley .
The authorized official title is Director Of Insurance and has the following contact phone number (864) 282-1935.

The enumeration date for this NPI number is 5/14/2020 and was last updated on 10/5/2020.

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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