# UPSTATE PEDIATRIC DENTISTRY, PA

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

## Provider details

- **NPI number:** 1275780454
- **Authorized official:** DR. BRIAN TIMOTHY JONES DMD (DENTIST)
- **Authorized official phone:** (864) 676-9873

## Contact information

- **Practice address:** 105-A HALTON ROAD, GREENVILLE, SC 29607-3507
- **Practice address phone:** (864) 676-9873
- **Practice address fax:** (864) 676-9870
- **Mailing address:** 105-A HALTON ROAD, GREENVILLE, SC 29607-3507
- **Mailing address phone:** (864) 676-9873
- **Mailing address fax:** (864) 676-9870

## Taxonomy

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

## Other

- **Enumeration date:** 08/19/2008
- **Last updated:** 08/19/2008