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General NPI Number Information
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NPI Number | 1295596344
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Entity Type | Individual
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Provider Name | SEAN T GANTHER DDS
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Gender | Male
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 1209 N RETAIL CT
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-9626
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Country | US
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Telephone | 415-502-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 200 TADLEY WAY MAILBOX 106
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City | MYRTLE BEACH
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State | SC
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Zip | 29588
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Country | US
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Telephone | 415-370-9940
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD10910
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License Number State | SC
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