Organization
PIEDMONT ORTHODONTIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST JASON GARDNER JR. DDS (OWNER ORTHODONTIST)
(864) 585-8709
Entity
Organization
Contact information
Practice address
319 NORTH PINE STREET, SUITE 5, SPARTANBURG, SC 29302-1622
(864) 585-8709
(864) 585-8700
Mailing address
319 NORTH PINE STREET, SUITE 5, SPARTANBURG, SC 29302-1622
(864) 585-8709
(864) 585-8700
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
332
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
SC1930
SC
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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