Individual
DR. SASANKOTI MOHAN RAVI PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2022020817
MO
1223G0001X
General Practice Dentistry
Primary
10463
SC
Other
Enumeration date
06/10/2022
Last updated
05/16/2023
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