Individual
DR. CHARLES WALDEN HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
121 NORTH PINE STREET, BATESBURG LEESVILLE, SC 29006
(803) 532-6146
(803) 532-5807
Mailing address
PO BOX 2409, 121 NORTH PINE STREET, BATESBURG LEESVILLE, SC 29070-0409
(803) 532-6146
(803) 532-5807
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1631
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z16313
—
SC
Enumeration date
01/11/2007
Last updated
07/08/2007
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