Provider Demographics
NPI:1548636699
Name:ALMQUIST, HENRY GUSTAV III (DMD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:GUSTAV
Last Name:ALMQUIST
Suffix:III
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 1:1000 PINE TOP RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-9539
Mailing Address - Country:US
Mailing Address - Phone:864-339-8171
Mailing Address - Fax:
Practice Address - Street 1:1000 PINE TOP RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:SC
Practice Address - Zip Code:29627-9539
Practice Address - Country:US
Practice Address - Phone:864-339-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist