Organization
FOOTHILLS ORAL & FACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR LEBEDOVYCH DDS (PRESIDENT)
(864) 967-4000
Entity
Organization
Contact information
Practice address
634 FAIRVIEW RD, BUILDING C, SIMPSONVILLE, SC 29680
(864) 967-4000
Mailing address
634 FAIRVIEW RD, BUILDING C, SIMPSONVILLE, SC 29680
(864) 967-4000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4084
SC
Other
Enumeration date
01/08/2007
Last updated
08/22/2020
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