Organization
FLEETWOOD DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIS ELY HAWKINS III DMD (OWNER)
(864) 855-2788
Entity
Organization
Contact information
Practice address
105 FLEETWOOD DR, EASLEY, SC 29640-2019
(864) 855-2788
(864) 855-2789
Mailing address
105 FLEETWOOD DR, EASLEY, SC 29640-2019
(864) 855-2788
(864) 855-2789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3264
SC
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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