**PLEASE NOTE: OUR OFFICE DOES NOT FILE WITH MEDICAID** First Name * Last Name * Email * Phone * Address Zip code Appointment Type ---Emergency ToothacheNew Patient CleaningFilling or Crown NeededDenture or Partial RepairOther Insurance Type ---Blue Cross Blue ShieldCignaDelta DentalHumanaUnited Health CareOtherI do not have insurance Comments **PLEASE NOTE: OUR OFFICE DOES NOT FILE WITH MEDICAID** Swansea Dental Care 533 St. Matthews Road Swansea, SC 29160 Fax: (803) 568-5252 (803) 568-2077
