Individual
DR. CHARLES EUGENE WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
27 E MAIN ST, WARE SHOALS, SC 29692-1338
(864) 456-2521
Mailing address
27 E MAIN ST, WARE SHOALS, SC 29692-1338
(864) 456-2521
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2843
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z28435
—
SC
Enumeration date
01/02/2007
Last updated
07/09/2007
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