| Dr. Tracy L. Durant, Inc. | |
|
1125 Anderson Rd N Sutie 104 Rock Hill SC 29730-2776 | |
| (803) 325-8178 | |
| Not Available |
| Full Name | Dr. Tracy L. Durant, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1125 Anderson Rd N, Rock Hill, South Carolina |
| Authorized Official Name and Position | Tracy Lyndell Durant (PRESIDENT / OWNER) |
| Authorized Official Contact | 80933258178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tracy L. Durant, Inc. 1125 Anderson Rd N Sutie 104 Rock Hill SC 29730-2776 Ph: (803) 325-8178 | Dr. Tracy L. Durant, Inc. 1125 Anderson Rd N Sutie 104 Rock Hill SC 29730-2776 Ph: (803) 325-8178 |
| NPI Number | 1164697405 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 04/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164697405 | NPI | - | NPPES |
| 3506 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3506 (South Carolina) | Primary |
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