Organization
UPSTATE ENDODONTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALLACE LYNDON GUILFORD III DMD (PRESIDENT)
(864) 699-9931
Entity
Organization
Contact information
Practice address
263 CALIFORNIA AVE, SPARTANBURG, SC 29303-2271
(864) 699-9931
(864) 432-2229
Mailing address
263 CALIFORNIA AVE, SPARTANBURG, SC 29303-2271
(864) 699-9931
(864) 432-2229
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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