Organization
DR. TRACY L. DURANT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY LYNDELL DURANT DDS (PRESIDENT / OWNER)
80933258178
Entity
Organization
Contact information
Practice address
1125 ANDERSON RD N, SUTIE 104, ROCK HILL, SC 29730-2776
(803) 325-8178
Mailing address
1125 ANDERSON RD N, SUTIE 104, ROCK HILL, SC 29730-2776
(803) 325-8178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3506
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3506
—
SC
Enumeration date
04/28/2008
Last updated
04/28/2008
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