RICHARD T. PROVINE

SPARTANBURG, SC
NPI1811074735
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: SC  1821)
Enumeration Date2006-11-01
Last Update Date2008-05-07
Business Address
Dr. RICHARD T. PROVINE D.M.D
1111 W O EZELL BLVD STE.A
SPARTANBURG, SC 29301-1655
Phone number: 864-576-0943
Mailing Address
Dr. RICHARD T. PROVINE D.M.D
108 AMBER DR
INMAN, SC 29349-9568
Phone number: 864-472-5708
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