| Holly Tree Pediatric Dentistry | |
|
1673 E Main St Easley SC 29640-3791 | |
| (864) 442-6770 | |
| (864) 442-6830 |
| Full Name | Holly Tree Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1673 E Main St, Easley, South Carolina |
| Authorized Official Name and Position | Ann M Bynum (VICE PRESIDENT) |
| Authorized Official Contact | 8644426770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holly Tree Pediatric Dentistry 1673 E Main St Easley SC 29640-3791 Ph: (864) 442-6770 | Holly Tree Pediatric Dentistry 1673 E Main St Easley SC 29640-3791 Ph: (864) 442-6770 |
| NPI Number | 1194181297 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 01/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194181297 | NPI | - | NPPES |
| ZA9157 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3427 (South Carolina) | Primary |
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