Georgina G Coffey, D.M.D.

Individual provider Active NPI General Practice Dentistry · Manning, SC

NPI 1972632644 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1972632644
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
SC3938 (SC)
Practice address
24 Bozard St
Manning, SC 29102-2935
Phone
(803) 435-8845
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SC3938SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Manning Dental Associates General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X SC3938 SC Yes

Addresses

Primary practice location

24 Bozard St
Manning, SC 29102-2935

Mailing address

24 Bozard St
P.O. Box 1291
Manning, SC 29102-2935
Phone (803) 435-8845

Other identifiers

IdentifierTypeStateIssuer
ZX3938MedicaidSC

Other providers in Manning, SC

All providers in Manning, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.