Individual
DR. VIVIEN ROSE EBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1987 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827
(803) 632-3301
Mailing address
5 VILLAGE ROW UNIT 532, BEAUFORT, SC 29906-7509
(484) 866-3479
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.10864
SC
Other
Enumeration date
07/23/2024
Last updated
08/19/2024
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