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Individual

DR. HARRELL LEE GARDNER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
935 W HOME AVE, HARTSVILLE, SC 29550-4435
(843) 383-4562
(843) 332-9701
Mailing address
PO BOX 969, HARTSVILLE, SC 29551-0969
(843) 383-4562
(843) 332-9701

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1800
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Z18008
SC
Enumeration date
06/25/2008
Last updated
08/26/2010
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