Organization
SOUTH CAROLINA DENTAL SLEEP CENTER, LLC
Active
Other names
South Carolina Dental Sleep, Five Forks
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH LOUISE ILLSLEY (DIRECTOR OF INSURANCE)
(864) 282-1935
Entity
Organization
Contact information
Practice address
216 SCUFFLETOWN RD STE A, SIMPSONVILLE, SC 29681-7296
(864) 207-7141
(864) 751-7329
Mailing address
110 VILLA RD, GREENVILLE, SC 29615-3010
(864) 282-1935
(864) 751-6387
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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