Organization
GREENVILLE PEDIATRIC DENTISTRY PA
Active
Other names
Drs. Wilson, Uprichard and Czarsty PA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY KNIGHT PORTER (INSURANCE CLAIMS MANAGER)
(864) 250-1100
Entity
Organization
Contact information
Practice address
1376 CLEVELAND ST, GREENVILLE, SC 29607-2435
(864) 250-1100
(864) 250-1604
Mailing address
1376 CLEVELAND ST, GREENVILLE, SC 29607-2435
(864) 250-1100
(864) 250-1604
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9752
—
SC
Enumeration date
10/17/2006
Last updated
06/10/2010
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