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General NPI Number Information
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NPI Number | 1386870657
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Entity Type | Individual
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Provider Name | RICHARD ANTHONY CONSTANTINE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 304 MILACRON DR
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City | FOUNTAIN INN
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State | SC
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Zip | 29644
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Country | US
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Telephone | 864-387-9748
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Fax |
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Provider Business Mailing Address
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Address Line | 207 SHALLONS DR
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City | GREENVILLE
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State | SC
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Zip | 29609-0982
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Country | US
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Telephone | 864-387-9748
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4587
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License Number State | SC
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