Individual
M L DENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
123 EPPS ST, LAKE CITY, SC 29560
(843) 374-5487
(843) 374-7342
Mailing address
PO BOX 1419, LAKE CITY, SC 29560-1419
(843) 374-5487
(843) 374-7342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
495
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D04957
—
SC
Enumeration date
11/03/2006
Last updated
05/05/2008
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