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Organization
WELVISTA
Active
Organization
WELVISTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA FAMULINER RN (SMILES OPERATIONS DIRECTOR)
(803) 584-4803
Entity
Organization
Contact information
Practice address
395 PINE ST E, VARNVILLE, SC 29944-9617
(803) 300-7028
(803) 584-4806
Mailing address
395 PINE ST E, VARNVILLE, SC 29944-9617
(803) 300-7028
(803) 584-4806
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
10/10/2017
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