Organization
CAROLINA CTR FOR ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY CLINTON BELK JR. DMD (PRESIDENT)
(864) 574-2011
Entity
Organization
Contact information
Practice address
115 POWELL MILL RD, SPARTANBURG, SC 29302-1531
(864) 574-2011
(864) 576-7377
Mailing address
115 POWELL MILL RD, SPARTANBURG, SC 29302-1531
(864) 574-2011
(864) 576-7377
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1723
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890651E
NC MEDICAID
NC
05
—
ZA9924
—
SC
Enumeration date
02/28/2007
Last updated
08/23/2013
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