Individual
TOM BADGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 9TH AVE, CONWAY, SC 29526-4107
(843) 248-3843
Mailing address
1515 9TH AVE, CONWAY, SC 29526-4107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1352
SC
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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