Individual
DR. LISSA DISPARANO GILREATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
241 STORK WAY, SENECA, SC 29678-1039
(864) 888-3102
Mailing address
112 WOODBURY CIR, TAYLORS, SC 29687-3758
(864) 404-6958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9173
SC
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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