Organization
WILLOUGHBY DENTAL PA
Active
Other names
Willoughby Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SCOTT WARNER D.D.S. (OWNER/DENTIST)
(864) 546-4242
Entity
Organization
Contact information
Practice address
3101 S. HWY 14, SUITE 4, GREENVILLE, SC 29615
(864) 546-4242
Mailing address
3101 S. HWY 14, SUITE 4, GREENVILLE, SC 29615
(864) 546-4242
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4579
SC
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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