Individual
DR. GORDON DAVID DANNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
701 BRUSHY CREEK ROAD, EASLEY, SC 29642
(864) 859-0103
(864) 859-0420
Mailing address
P. O. BOX 1668, EASLEY, SC 29641-1668
(864) 859-0103
(864) 859-0420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC2255
SC
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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