Individual
GUILHERME FARIA MOURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
173 ASHLEY AVE # BSB550P, CHARLESTON, SC 29425-8908
(843) 792-8181
Mailing address
173 ASHLEY AVE # BSB550P, CHARLESTON, SC 29425-8908
(843) 792-8181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
57
SC
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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