Organization
CONESTEE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED ROBERT BURR DDS (OWNER)
(864) 277-1603
Entity
Organization
Contact information
Practice address
409 DONALDSON RD, GREENVILLE, SC 29605-3713
(864) 277-1603
Mailing address
409 DONALDSON RD, GREENVILLE, SC 29605-3713
(864) 277-1603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2021
SC
1223G0001X
General Practice Dentistry
Primary
8728
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639528250
PERSONAL NPI
SC
Enumeration date
10/16/2017
Last updated
10/17/2017
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