Organization
BEREA COMPREHENSIVE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIR JIM NASIM DMD (DENTIST)
(864) 246-2181
Entity
Organization
Contact information
Practice address
701 SULPHUR SPRINGS RD, GREENVILLE, SC 29617-1913
(864) 246-2181
Mailing address
701 SULPHUR SPRINGS RD, GREENVILLE, SC 29617-1913
(864) 246-2181
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2881
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9490
—
SC
Enumeration date
01/04/2007
Last updated
08/22/2020
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