# OMSCOR LLC

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

## Provider details

- **NPI number:** 1679178206
- **Authorized official:** DR. BRETT SHIGLEY DMD, MS (PRESIDENT)
- **Authorized official phone:** (864) 420-2738

## Contact information

- **Practice address:** 218 WALL ST, POWDERSVILLE, SC 29673-6754
- **Practice address phone:** (864) 420-2738
- **Mailing address:** 1140 WOODRUFF RD STE 106-180, GREENVILLE, SC 29607-4172
- **Mailing address phone:** (864) 420-2738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/01/2020
- **Last updated:** 12/01/2020