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1750949020
KOURTLAND HAILE
COLUMBIA, SC
NPI
1750949020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: SC 9376)
Enumeration Date
2019-06-03
Last Update Date
2019-06-03
Business Address
KOURTLAND HAILE
2020 LAUREL ST
COLUMBIA, SC 29204-1019
Phone number: 803-524-4543
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Mailing Address
KOURTLAND HAILE
2020 LAUREL ST
COLUMBIA, SC 29204-1019
Phone number: 803-524-4543
Copy
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