Individual
ROBERT BRAGA HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10266 TWO NOTCH RD, COLUMBIA, SC 29229-4400
(803) 563-6942
Mailing address
751 MALLET ROAD APT. 8207, COLUMBIA, SC 29223
(701) 552-2974
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8433
SC
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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