Individual
DR. RICHARD GLENN JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16 MILLS AVE, UNIT #1, GREENVILLE, SC 29605-4070
(864) 242-4848
Mailing address
16 MILLS AVE, STE 1, GREENVILLE, SC 29605-4065
(864) 242-4848
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
02333
SC
Other
Enumeration date
02/15/2007
Last updated
02/15/2016
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