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Organization
LIBERTY DENTAL CARE, INC.
Active
Organization
LIBERTY DENTAL CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES L WILSON DMD (GENERAL DENTIST)
(864) 843-3742
Entity
Organization
Contact information
Practice address
207 W FRONT ST, LIBERTY, SC 29657-1009
(864) 843-3742
(864) 843-3744
Mailing address
207 W FRONT ST, LIBERTY, SC 29657-1009
(864) 843-3742
(864) 843-3744
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3144
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z31449
—
SC
Enumeration date
05/08/2008
Last updated
05/08/2008
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