Organization
PALMETTO PERIODONTICS OF GREENVILLE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM FREDRICK BOHLEN DMD (OWNER)
(864) 987-9700
Entity
Organization
Contact information
Practice address
1130 E BUTLER RD, GREENVILLE, SC 29607-5908
(864) 987-9700
(864) 987-0198
Mailing address
1130 E BUTLER RD, GREENVILLE, SC 29607-5908
(864) 987-9700
(864) 987-0198
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6919
SC
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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