# UPSTATE ENDODONTICS, INC.

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

## Provider details

- **NPI number:** 1508473265
- **Authorized official:** DR. WALLACE LYNDON GUILFORD III DMD (PRESIDENT)
- **Authorized official phone:** (864) 699-9931

## Contact information

- **Practice address:** 263 CALIFORNIA AVE, SPARTANBURG, SC 29303-2271
- **Practice address phone:** (864) 699-9931
- **Practice address fax:** (864) 432-2229
- **Mailing address:** 263 CALIFORNIA AVE, SPARTANBURG, SC 29303-2271
- **Mailing address phone:** (864) 699-9931
- **Mailing address fax:** (864) 432-2229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 09/28/2020
- **Last updated:** 09/28/2020