Individual
DR. FREDERICK EARLE BROGDON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
634 BULTMAN DR, SUMTER, SC 29150-2550
(803) 775-4368
(803) 775-1268
Mailing address
460 PRINGLE DR, SUMTER, SC 29150-3235
(803) 775-3440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2156
SC
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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