Individual
DR. THEODORE D RAVENEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
115 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 794-8371
(803) 794-7060
Mailing address
115 PROFESSIONAL AVE, WEST COLUMBIA, SC 29169-4711
(803) 794-8371
(803) 794-7060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1343
SC
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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