Provider Demographics
NPI:1902951940
Name:UNION DENTAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:UNION DENTAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEWMAN
Authorized Official - Middle Name:CARLISLE
Authorized Official - Last Name:MCGARITY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-427-2264
Mailing Address - Street 1:103C S BOYCE ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-2203
Mailing Address - Country:US
Mailing Address - Phone:864-427-2264
Mailing Address - Fax:864-427-8373
Practice Address - Street 1:103C S BOYCE ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-2203
Practice Address - Country:US
Practice Address - Phone:864-427-2264
Practice Address - Fax:864-427-8373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX9744Medicaid