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Organization
OMSCOR LLC
Active
Organization
OMSCOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT SHIGLEY DMD, MS (PRESIDENT)
(864) 420-2738
Entity
Organization
Contact information
Practice address
218 WALL ST, POWDERSVILLE, SC 29673-6754
(864) 420-2738
Mailing address
1140 WOODRUFF RD STE 106-180, GREENVILLE, SC 29607-4172
(864) 420-2738
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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