Healthcare Provider Details

I. General information

NPI: 1770521304
Provider Name (Legal Business Name): DR. ALAN DAVID OWINGS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W MARTINTOWN RD
NORTH AUGUSTA SC
29841-1101
US

IV. Provider business mailing address

540 W MARTINTOWN RD
NORTH AUGUSTA SC
29841-1101
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-9346
  • Fax: 803-279-9000
Mailing address:
  • Phone: 803-279-9346
  • Fax: 803-279-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3182
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: