Organization
REGENESIS ORGANZATION COMMUNITY HEALTH CENTER
Active
Parent organization
REGENESIS ORGANZATION COMMUNITY HEALTH CENTER
Other names
ReGenesis Community Health Center Dental Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
REGENESIS ORGANZATION COMMUNITY HEALTH CENTER
Authorized official
GEORGE NEWBY (CEO)
(864) 582-2817
Entity
Organization
Contact information
Practice address
550 S CHURCH STREET, UNIT 2, SPARTANBURG, SC 29306-3306
(864) 582-2817
Mailing address
PO BOX 5158, SPARTANBURG, SC 29304-5158
(864) 582-2817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9355
—
SC
Enumeration date
12/07/2009
Last updated
06/03/2010
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