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Individual

DR. CHALBOURNE RUTLEDGE BRASINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
133 BENNETT ST, GREENVILLE, SC 29601-1605
(864) 412-1007
(864) 412-1009
Mailing address
133 BENNETT ST, GREENVILLE, SC 29601-1605
(864) 412-1007
(864) 412-1009

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3766
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX3766
SC
Enumeration date
01/11/2007
Last updated
08/16/2013
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