Organization
JIM NASIM
Active
Other names
Carolina Dental Docs of Greenwood
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA MARTIN (HR MANAGER)
(770) 382-3536
Entity
Organization
Contact information
Practice address
101 WEST DURST AVENUE, GREENWOOD, SC 29649
(864) 576-7169
Mailing address
101 WEST DURST AVENUE, GREENWOOD, SC 29649
(864) 576-7169
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2881
SC
1223P0221X
Pediatric Dentistry
2881
SC
Other
Enumeration date
09/11/2015
Last updated
05/10/2017
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