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General NPI Number Information
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NPI Number | 1306041504
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Entity Type | Organization
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Legal Business Name | DAN R YARBROUGH,D.M.D.
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 100 COMMERCE ST # A
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City | WALTERBORO
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State | SC
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Zip | 29488-2943
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Country | US
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Telephone | 843-549-7422
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Fax | 843-549-6017
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Provider Business Mailing Address
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Address Line | 100 COMMERCE ST # A
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City | WALTERBORO
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State | SC
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Zip | 29488-2943
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Country | US
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Telephone | 843-549-7422
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Fax | 843-549-6017
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAN R YARBROUGH
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Credential | D.M.D.
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Telephone | 843-549-7422
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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 | 2768
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License Number State | SC
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