Terrence L Vandiver

NPI #1306811914 in Augusta, Georgia

Provider Information

NPI Number: 1306811914
Entity Type: Individual
Name: Terrence L Vandiver
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 18, 2006
Last Updated: Mar 26, 2015

Practice Location

Address: 1631 GORDON HWY
Address 2: #22
City: Augusta
State: Georgia
ZIP Code: 30906-2292
Phone: (706) 790-9302

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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