Individual
DR. RONALD BRENT CALCUTT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., P.A.
Contact information
Practice address
703 N MAIN ST, FOUNTAIN INN, SC 29644-1611
(864) 862-2966
(864) 862-2112
Mailing address
508 WALKINGSTICK WAY, SIMPSONVILLE, SC 29680-7216
(864) 228-7297
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3875
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9535
—
SC
Enumeration date
05/19/2006
Last updated
07/09/2007
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