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Organization

JIM NASIM DMD PA

Active
Parent organization
JIM NASIM DMD PA
Other names
Hall Street Family Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
JIM NASIM DMD PA
Authorized official
JENNI TOMLINSON (CREDENTIALING SPECIALIST)
(864) 582-5915
Entity
Organization

Contact information

Practice address
162 HALL ST, SPARTANBURG, SC 29302-1524
(864) 582-5915
(864) 582-1076
Mailing address
162 HALL ST, SPARTANBURG, SC 29302-1524
(864) 582-5915
(864) 582-1076

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
261QD0000X
Dental Clinic/Center
2881
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZA9703
SC
Enumeration date
05/30/2008
Last updated
03/04/2024
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