Organization
FALLS PARK DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN RUSSELL DERRICK D.M.D. (DENTIST/PRESIDENT)
(864) 243-8371
Entity
Organization
Contact information
Practice address
104 N MAIN ST, GREENVILLE, SC 29601-2721
(864) 243-8371
Mailing address
104 N MAIN ST, GREENVILLE, SC 29601-2721
(864) 243-8371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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