Organization
DR. GEORGE H. FANN, D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD ELLIOTT (OWNER)
(803) 796-0666
Entity
Organization
Contact information
Practice address
111 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 796-0666
(803) 796-8753
Mailing address
111 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 796-0666
(803) 796-8753
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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