Organization
EASTSIDE PEDIATRIC DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN ROBERT HEAD DMD (OWNER)
(864) 233-1234
Entity
Organization
Contact information
Practice address
6 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 233-1234
(864) 298-8009
Mailing address
6 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 233-1234
(864) 298-8009
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2868
SC
Other
Enumeration date
02/09/2006
Last updated
10/31/2012
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