Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 1985 | SC |
NPI | 1043342629 |
---|---|
Provider Name | Dr. Alvin Harold Danenberg |
First Address | Charleston, SC 29414-9124 |
Second Address | West Columbia, SC 29169-3428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2007 |
Last Update Date | 08/07/2007 |