Provider First Line Business Practice Location Address:
MAIL STOP 1122
Provider Second Line Business Practice Location Address:
GREENVILLE TECHNICAL COLLEGE, DENTAL PROGRAMS
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29606-5616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-250-8074
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/08/2009