Individual
DR. JOMPOBE VUTHIGANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
173 ASHLEY AVE, BSB RM 546, CHARLESTON, SC 29425-8908
(843) 792-2341
Mailing address
PO BOX 1266, RIDGELAND, SC 29936-2621
(843) 870-8555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4600
SC
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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