Individual
DR. RONALD VAN FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
301 E BLACKSTOCK RD, SPARTANBURG, SC 29301-3737
(864) 576-8040
(864) 576-1759
Mailing address
PO BOX 170007, SPARTANBURG, SC 29301-0020
(864) 576-8040
(864) 576-1759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2576
SC
Other
Enumeration date
11/21/2006
Last updated
03/27/2012
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