Organization
PRIME DENTAL OF WOODRUFF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASA DUNCAN SHIRLEY III DMD (OWNER)
(864) 834-8001
Entity
Organization
Contact information
Practice address
420 S MAIN ST, WOODRUFF, SC 29388-2117
(864) 476-3212
(864) 476-3212
Mailing address
420 S MAIN ST, WOODRUFF, SC 29388-2117
(864) 476-3212
(864) 476-3212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1863
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9487
—
SC
Enumeration date
12/14/2006
Last updated
08/22/2020
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