Organization
BEREA DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMIE R FOSTER (OFFICE ADMINISTRATOR)
(864) 235-3949
Entity
Organization
Contact information
Practice address
1906 CEDAR LANE RD, GREENVILLE, SC 29617-1733
(864) 235-3949
Mailing address
1906 CEDAR LANE RD, GREENVILLE, SC 29617-1733
(864) 235-3949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC4479
SC
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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