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Individual

HENRY OTTO LORIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
943 S IRBY ST, SUITE A, FLORENCE, SC 29501-5217
(843) 673-0075
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2422
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
229140
SC
Enumeration date
03/17/2006
Last updated
12/28/2010
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