Individual
MR. ALLEN NATHANIEL GUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
113 MAGNOLIA STREET, WALTERBORO, SC 29488-0027
(843) 549-1215
Mailing address
PO BOX 402, WALTERBORO, SC 29488-0027
(843) 549-1215
(843) 549-1835
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3851
VA
122300000X
Dentist
Primary
SC1532
SC
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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