Organization
UPSTATE ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Parent organization
UPSTATE ORAL AND MAXILLOFACIAL SURGERY, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
UPSTATE ORAL AND MAXILLOFACIAL SURGERY, P.A.
Authorized official
DR. WIILIAM P. MILLS JR. DMD (OWNER)
(864) 585-3318
Entity
Organization
Contact information
Practice address
280 NORTH GROVE MEDICAL PARK DR., SPARTANBURG, SC 29303-4222
(864) 585-3318
(864) 585-4800
Mailing address
280 NORTH GROVE MEDICAL PARK DRIVE, SPARTANBURG, SC 29303-4222
(864) 585-3318
(864) 585-4800
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2121
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2143
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z21218
—
SC
05
—
Z21432
—
SC
05
—
ZA9899
—
SC
Enumeration date
02/22/2007
Last updated
01/06/2011
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