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Individual

DAVID LATHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
960 CIPRIANA DR UNIT B6, MYRTLE BEACH, SC 29572-4627
(843) 839-9552
Mailing address
2521 GREAT SCOTT DR, MYRTLE BEACH, SC 29579-3619

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
58369
CA
122300000X
Dentist
7480754-9922
UT
122300000X
Dentist
Primary
8462
SC

Other

Enumeration date
06/29/2009
Last updated
01/08/2016
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