Individual
VITALII OMELIANCIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3227 W BLUE RIDGE DR, GREENVILLE, SC 29611
(864) 295-8888
(864) 295-1241
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(215) 919-1658
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8989
SC
1223G0001X
General Practice Dentistry
Primary
8989
SC
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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