Individual
DR. HOLLY MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4004 BAYBORO ST, LORIS, SC 29569-2867
(843) 756-2273
(843) 756-0242
Mailing address
4004 BAYBORO ST, LORIS, SC 29569-2867
(843) 756-2273
(843) 756-0242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4487
SC
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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