Provider Demographics
NPI:1588750632
Name:TOWNES, GEORGE A (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:TOWNES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BUCK ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-5936
Mailing Address - Country:US
Mailing Address - Phone:843-706-2146
Mailing Address - Fax:843-706-2149
Practice Address - Street 1:15 BUCK ISLAND RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5936
Practice Address - Country:US
Practice Address - Phone:843-706-2146
Practice Address - Fax:843-706-2149
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3626Medicaid