# PEDIATRIC DENTISTRY OF GREENWOOD, P.A.

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

## Provider details

- **NPI number:** 1215188388
- **Authorized official:** DR. JENNIFER BALKCUM TURNER (DENTIST)
- **Authorized official phone:** (864) 229-0305

## Contact information

- **Practice address:** 1202B HWY 72 W, GREENWOOD, SC 29649-1816
- **Practice address phone:** (864) 229-0305
- **Mailing address:** 1202B HWY 72 W, GREENWOOD, SC 29649-1816
- **Mailing address phone:** (864) 229-0305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | SC4112 | SC | Yes |

## Other

- **Enumeration date:** 10/07/2008
- **Last updated:** 10/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZX4050 | — | SC |
| 05 | — | ZX4112 | — | SC |