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General NPI Number Information
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NPI Number | 1235501024
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Entity Type | Organization
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Legal Business Name | ELIZABETH ARNETT JABBOUR DMD
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 402 S PINE ST
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City | SPARTANBURG
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State | SC
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Zip | 29302-2712
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Country | US
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Telephone | 864-582-2371
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Fax | 864-585-1949
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Provider Business Mailing Address
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Address Line | 402 S PINE ST
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City | SPARTANBURG
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State | SC
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Zip | 29302-2712
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Country | US
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Telephone | 864-582-2371
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Fax | 864-585-1949
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | MARY ELIZABETH ARNETT JABBOUR
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Credential | DMD
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Telephone | 864-582-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3148
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License Number State | SC
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