Sea Glass Periodontics of Greenville
Sea Glass Periodontics of Greenville provides Periodontics in Greenville, South Carolina. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
600 Congaree RdGreenville, SC 29607-3518
Phone: (864) 757-8820
Fax: (864) 751-6387
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X |
|---|
Record details
| NPI number | 1568084408 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Sea Glass Periodontics, LLC |
| Authorized official | Beth Illsley — Director Of Insurance · (864) 282-1935 |
| Other names | Sea Glass Periodontics Of Greenville; Diane Jenkins Periodontics Of Congaree Llc; Diane Jenkins Periodontics Of Congaree Llc |
| NPI enumerated | May 14, 2020 |
| Last updated in NPPES | October 9, 2024 |
| Certification date | October 9, 2024 |
| Mailing address | 400 Memorial Drive Ext Ste 400, Greer, SC 29651-1850 |
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