Individual
JOHN POLYDOROU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
103 GREENLAND DR, GOOSE CREEK, SC 29445-5354
(843) 553-4400
Mailing address
5000 COLLEGE DR, SPARTANBURG, SC 29303-6614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8990
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9687
SC
Other
Enumeration date
10/24/2019
Last updated
08/10/2022
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