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Organization
SIMPSONVILLE DENTAL ASSOCIATES PA
Active
Organization
SIMPSONVILLE DENTAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKS A GODWIN DMD (DOCTOR PARTNER)
(864) 963-3601
Entity
Organization
Contact information
Practice address
315 W GEORGIA RD, SIMPSONVILLE, SC 29681-2401
(864) 963-3601
(864) 963-2598
Mailing address
PO BOX 799, SIMPSONVILLE, SC 29681-0799
(864) 963-3601
(864) 963-2598
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1363835
UNITED CONCORDIA
—
Enumeration date
11/01/2005
Last updated
08/22/2020
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