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Individual

BRANDON WALKER WHITWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1040 S PENDLETON ST STE C, EASLEY, SC 29642-1047
(864) 306-0800
Mailing address
1040 S. PENDLETON ST UNIT C, EASLEY, SC 29642
(864) 306-0800

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8149
SC

Other

Enumeration date
10/08/2012
Last updated
10/08/2012
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