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Organization
DENTISTRY AT SIMPSONVILLE
Active
Organization
DENTISTRY AT SIMPSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J MCCOY D.M.D. (OWNER/DENTIST)
(864) 228-9112
Entity
Organization
Contact information
Practice address
1219 W GEORGIA RD, SIMPSONVILLE, SC 29680-6335
(864) 228-9112
(864) 228-9152
Mailing address
1219 W GEORGIA RD, SIMPSONVILLE, SC 29680-6335
(864) 228-9112
(864) 228-9152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3610
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3610
SOUTH CAROLINA STATE BOARD OF DENTISTRY LICENSE NO
SC
Enumeration date
01/13/2015
Last updated
01/13/2015
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