Organization
CAROLINA PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA SPIVEY GREEN DMD (DENTIST)
(864) 585-8558
Entity
Organization
Contact information
Practice address
763 E. MAIN STREET, SPARTANBURG, SC 29302
(864) 585-8558
(864) 580-4242
Mailing address
763 E. MAIN STREET, SPARTANBURG, SC 29302
(864) 585-8558
(864) 580-4242
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3703
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX3703
—
SC
Enumeration date
06/03/2011
Last updated
01/31/2024
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