Provider Demographics
NPI:1720427594
Name:BILLINGTON, ELYSE MARIE MAIORINI (DMD)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:MARIE MAIORINI
Last Name:BILLINGTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 INDIA HOOK RD STE 207
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1326
Mailing Address - Country:US
Mailing Address - Phone:803-328-8004
Mailing Address - Fax:
Practice Address - Street 1:2460 INDIA HOOK RD STE 207
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1326
Practice Address - Country:US
Practice Address - Phone:803-328-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85291223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice