Organization
LUCIUS F WATES DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCIUS FRANKLIN WATES DMD (PRES. OF CORPORATION)
(843) 355-9295
Entity
Organization
Contact information
Practice address
509 THURGOOD MARSHALL HWY, KINGSTREE, SC 29556-4107
(843) 355-9295
(843) 355-9296
Mailing address
509 THURGOOD MARSHALL HWY, KINGSTREE, SC 29556-4107
(843) 355-9295
(843) 355-9296
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1904
SC
Other
Enumeration date
03/29/2007
Last updated
08/22/2020
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