Organization
CEDAR BLUFF FAMILY AND COSMETIC DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY R BAYER (PRESIDENT)
(864) 962-6787
Entity
Organization
Contact information
Practice address
634 B FAIRVIEW RD, SUITE 1, SIMPSONVILLE, SC 29860
(864) 962-6787
Mailing address
634B FAIRVIEW RD STE 1, SIMPSONVILLE, SC 29680-6700
(864) 962-6787
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/23/2007
Last updated
04/24/2024
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