Organization
RENEE G SHONGO DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENEE G SHONGO DMD PA (DENTIST PRACTICE OWNER)
(803) 794-0905
Entity
Organization
Contact information
Practice address
163 MEDICAL CIRCLE, WEST COLUMBIA, SC 29169-3655
(803) 794-0905
(803) 794-5472
Mailing address
163 MEDICAL CIRCLE, WEST COLUMBIA, SC 29169-3655
(803) 794-0905
(803) 794-5472
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2575
SC
Other
Enumeration date
09/05/2006
Last updated
01/31/2013
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