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Individual

MR. GROVER EDENS RABON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
669B WEST WESMARK BLVD, SUMTER, SC 29150
(803) 905-3567
(803) 905-3507
Mailing address
669B WEST WESMARK BLVD, SUMTER, SC 29150
(803) 905-3567
(803) 905-3507

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3460
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX3460
SC
Enumeration date
12/28/2006
Last updated
07/08/2007
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