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Individual

DR. KATHRYN STROUD BULLWINKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
405 W 5TH NORTH ST STE A, SUMMERVILLE, SC 29483-6515
(843) 821-6433
(843) 821-6432
Mailing address
405 W 5TH NORTH ST STE A, SUMMERVILLE, SC 29483-6515
(843) 821-6433
(843) 821-6432

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019028771
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8360
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8360
DENTAL SPECIALTY LICENSE
SC
Enumeration date
08/22/2012
Last updated
07/21/2022
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