Organization
WILLIAMS AND TANNER, D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STAFFORD DALE TANNER D.M.D. (DENTIST)
(843) 884-5166
Entity
Organization
Contact information
Practice address
1065 JOHNNIE DODDS BLVD STE A, MT PLEASANT, SC 29464-6153
(843) 884-5166
Mailing address
1065 JOHNNIE DODDS BLVD STE A, MT PLEASANT, SC 29464-6153
(843) 884-5166
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2601
SC
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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