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General NPI Number Information
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NPI Number | 1275694697
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Entity Type | Individual
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Provider Name | THOMAS B GUE JR. DMD
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 695 LAUREL ST
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City | ORANGEBURG
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State | SC
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Zip | 29115-4834
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Country | US
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Telephone | 803-536-6440
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Fax | 803-268-9921
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Provider Business Mailing Address
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Address Line | 1801 COLUMBIA RD
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City | ORANGEBURG
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State | SC
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Zip | 29115-3337
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Country | US
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Telephone | 803-536-6440
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Fax | 803-268-9921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4104
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License Number State | SC
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