Individual
MR. ANTHONY WAYNE ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
122 N BRICKYARD RD, COLUMBIA, SC 29223-6902
(803) 378-0142
Mailing address
801 BEASON RD, ORANGEBURG, SC 29115-8915
(803) 378-0142
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4370
SC
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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