# FOOTHILLS ORAL & FACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134549629
- **Authorized official:** VICTOR P LEBEDOVYCH DDS (PRESIDENT/CEO)
- **Authorized official phone:** (864) 967-4000

## Contact information

- **Practice address:** 301 W BELTLINE BLVD, \#301, ANDERSON, SC 29625-1505
- **Practice address phone:** (864) 967-4000
- **Practice address fax:** (864) 328-9907
- **Mailing address:** 301 W BELTLINE BLVD, \#301, ANDERSON, SC 29625-1505
- **Mailing address phone:** (864) 967-4000
- **Mailing address fax:** (864) 328-9907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4084 | SC | Yes |

## Other

- **Enumeration date:** 04/23/2014
- **Last updated:** 04/23/2014