Individual
DR. CRYSTAL H ISENHOWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
107 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8902
(843) 234-3110
(843) 234-3109
Mailing address
107 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8902
(843) 234-3110
(843) 234-3109
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3529
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9675
—
SC
Enumeration date
01/28/2008
Last updated
01/28/2008
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