Individual
KENNETH STEVEN BARRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
682 JOHNNIE DODDS BLVD STE 102, MT PLEASANT, SC 29464-3028
(843) 849-9044
Mailing address
682 JOHNNIE DODDS BLVD STE 102, MT PLEASANT, SC 29464-3028
(843) 849-9044
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
3150
SC
Other
Enumeration date
07/10/2008
Last updated
08/03/2011
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