Organization
PRIME DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASA DUNCAN SHIRLEY III DMD (OWNER)
(864) 864-8001
Entity
Organization
Contact information
Practice address
28 S MAIN ST, TRAVELERS REST, SC 29690-1810
(864) 834-8001
(864) 834-5563
Mailing address
28 S MAIN ST, P. O. BOX 987, TRAVELERS REST, SC 29690-1810
(864) 834-8001
(864) 834-5563
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1863
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9532
—
SC
Enumeration date
12/12/2006
Last updated
08/22/2020
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