Organization
VISTA SMILES OF COLUMBIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY JOSEPH WYCH DDS (OWNER)
(803) 779-9666
Entity
Organization
Contact information
Practice address
515 RICHLAND ST, COLUMBIA, SC 29201-2320
(803) 779-9666
(803) 779-4622
Mailing address
515 RICHLAND ST, COLUMBIA, SC 29201-2320
(803) 779-9666
(803) 779-4622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2905
SC
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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