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Oral Surgery, Dental Specialists

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CAROLINA CTR FOR ORAL & MAXILLOFACIAL SURGERY

Oral and Maxillofacial Surgery

Spartanburg, South Carolina

Provider NPI: 1144358623

Organization Information:
Organization Name:  CAROLINA CTR FOR ORAL & MAXILLOFACIAL SURGERY
Organization is not Subpart
Authorized Official:  HARRY CLINTON BELK  PRESIDENT  864-5742011

Practice Location:
115 POWELL MILL RD  SPARTANBURG, SC 29302 US
Tel: 864-574-2011  Fax: 864-576-7377

Business Mailing Address:
115 POWELL MILL RD  SPARTANBURG, SC 29302 US
Tel: 864-574-2011  Fax: 864-576-7377

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223S0112XDental Providers
Dentist
Oral and Maxillofacial Surgery
SC1723

Other Provider Identifiers:

IssuerNumberStateType
ZA9924SC05
NC MEDICAID890651ENC01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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