Organization
MIRROR LAKE FAMILY DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM PHILLIP SWINDERMAN III D.D.S. (DENTIST)
(216) 287-8921
Entity
Organization
Contact information
Practice address
54A POINTE CIR, GREENVILLE, SC 29615-3506
(864) 235-0175
Mailing address
54A POINTE CIR, GREENVILLE, SC 29615-3506
(864) 235-0175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4499
SC
Other
Enumeration date
04/15/2014
Last updated
04/23/2014
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