Individual
DR. GREGORY FARRIS SHANBOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
604B NEXTON SQUARE DR, SUMMERVILLE, SC 29486-7914
(405) 650-0337
Mailing address
604B NEXTON SQUARE DR, SUMMERVILLE, SC 29486-7914
(405) 650-0337
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6549
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2012
Last updated
01/06/2025
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