Healthcare Provider Details

I. General information

NPI: 1427460047
Provider Name (Legal Business Name): EUGENE SIBAL D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 MCNEELY RD
POWDERSVILLE SC
29673-9430
US

IV. Provider business mailing address

132 MCNEELY RD
POWDERSVILLE SC
29673-9430
US

V. Phone/Fax

Practice location:
  • Phone: 864-509-0040
  • Fax:
Mailing address:
  • Phone: 864-509-0040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8375
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: