Organization
GREENVILLE SMILES P.A.
Active
Other names
Greenville Family & Implant Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD STANLEY WILSON DMD (DENTIST/OWNER)
(864) 244-7135
Entity
Organization
Contact information
Practice address
140 MALL CONNECTOR RD, SUITE 6A, GREENVILLE, SC 29607
(864) 244-7135
(864) 268-2428
Mailing address
140 MALL CONNECTOR RD, SUITE 6A, GREENVILLE, SC 29607
(864) 244-7135
(864) 268-2428
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3603
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9622
—
SC
Enumeration date
10/17/2006
Last updated
06/21/2018
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