# PEDIATRIC DENTISTRY, PA

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

## Provider details

- **NPI number:** 1306999115
- **Authorized official:** MARK V MUNCY DMD (PEDODONTIST)
- **Authorized official phone:** (864) 877-3232

## Contact information

- **Practice address:** 420 THE PKWY STE B, GREER, SC 29650-5206
- **Practice address phone:** (864) 877-3232
- **Practice address fax:** (864) 677-3773
- **Mailing address:** 420 THE PKWY STE B, GREER, SC 29650-5206
- **Mailing address phone:** (864) 877-3232
- **Mailing address fax:** (864) 677-3773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3515 | SC | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZA9647 | — | SC |