Individual
DR. JUSTIN STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
121 N PINE ST, BATESBURG LEESVILLE, SC 29006-1974
(803) 532-6146
Mailing address
121 N PINE ST, BATESBURG, SC 29006-1974
(803) 532-6146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.9903
SC
Other
Enumeration date
06/09/2021
Last updated
09/11/2022
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