Individual
UPASNA MUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411030
VA
Other
Enumeration date
07/11/2014
Last updated
06/19/2020
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