Individual
DR. LATHONIA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
PO BOX 1010, KINGSTREE, SC 29556-1010
(843) 800-0087
(866) 379-9998
Mailing address
PO BOX 1010, KINGSTREE, SC 29556-1010
(912) 996-3303
(866) 379-9998
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12503
GA
122300000X
Dentist
25317
FL
122300000X
Dentist
Primary
3809
SC
1223G0001X
General Practice Dentistry
3809
SC
1223P0221X
Pediatric Dentistry
3809
SC
Other
Enumeration date
04/09/2007
Last updated
04/24/2024
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