Individual
D ALTON FANNING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1264 RIBAUT ROAD, STE 401, BEAUFORT, SC 29902
(843) 524-7950
(843) 525-1151
Mailing address
1264 RIBAUT ROAD, STE 401, BEAUFORT, SC 29902
(843) 524-7950
(843) 525-1151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC3162
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
783979
UNITED CONCORDIA
—
05
—
ZA9748
—
SC
Enumeration date
08/04/2006
Last updated
07/08/2007
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