Individual
MICAH J PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4323 HILL ST, COLUMBIA, SC 29207-6022
(803) 751-4512
Mailing address
4323 HILL ST, COLUMBIA, SC 29207-6022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12330675-9922
UT
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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