Provider Demographics
NPI:1992037824
Name:DENTALWORKS OF GREENVILLE SC, P.C.
Entity Type:Organization
Organization Name:DENTALWORKS OF GREENVILLE SC, P.C.
Other - Org Name:DENTALWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZASSO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:864-284-0066
Mailing Address - Street 1:PO BOX 860036
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0036
Mailing Address - Country:US
Mailing Address - Phone:864-284-0066
Mailing Address - Fax:216-584-1152
Practice Address - Street 1:4 MARKET POINT DRIVE
Practice Address - Street 2:SUITE E
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6558
Practice Address - Country:US
Practice Address - Phone:864-284-0066
Practice Address - Fax:216-584-1152
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTALONE PARTNERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-03
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty