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Organization

PEDIATRIC DENTISTRY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK V MUNCY DMD (PEDODONTIST)
(864) 877-3232
Entity
Organization

Contact information

Practice address
420 THE PKWY STE B, GREER, SC 29650-5206
(864) 877-3232
(864) 677-3773
Mailing address
420 THE PKWY STE B, GREER, SC 29650-5206
(864) 877-3232
(864) 677-3773

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3515
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9647
SC
Enumeration date
01/18/2007
Last updated
08/22/2020
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