Organization
AUGUSTA STREET DENTAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYWANA M GROCE DMD (PRESIDENT)
(864) 232-8393
Entity
Organization
Contact information
Practice address
813 AUGUSTA STREET, GREENVILLE, SC 29605
(864) 232-8393
(864) 242-6944
Mailing address
111 WHISPERING PINES LANE, GREENWOOD, SC 29646
(864) 232-8393
(864) 242-6944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4483
SC
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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