Organization
PEDIATRIC DENTISTRY OF GREENWOOD, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER BALKCUM TURNER (DENTIST)
(864) 229-0305
Entity
Organization
Contact information
Practice address
1202B HWY 72 W, GREENWOOD, SC 29649-1816
(864) 229-0305
Mailing address
1202B HWY 72 W, GREENWOOD, SC 29649-1816
(864) 229-0305
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
SC4112
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4050
—
SC
05
—
ZX4112
—
SC
Enumeration date
10/07/2008
Last updated
10/07/2008
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