Organization
LATTA SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAEFORD LEE CLANTON III DMD (OWNER)
(843) 752-7655
Entity
Organization
Contact information
Practice address
203 S MARION ST, LATTA, SC 29565-1522
(843) 752-7655
(843) 752-4500
Mailing address
203 S MARION ST, LATTA, SC 29565-1522
(843) 752-7655
(843) 752-4500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1920
SC
Other
Enumeration date
06/25/2007
Last updated
08/22/2020
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