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Organization
KEVIN G. EUBANKS, D.M.D
Active
Organization
KEVIN G. EUBANKS, D.M.D
Active
Other names
Southern Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI GRAY (BUSINESS COORDINATOR)
(803) 641-3883
Entity
Organization
Contact information
Practice address
174 CREPE MYRTLE DRIVE, AIKEN, SC 29803
(803) 641-3883
Mailing address
174 CREPE MYRTLE DRIVE, AIKEN, SC 29803
(803) 641-3883
(803) 641-3198
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3587
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3587
SOUTH CAROLINA BOARD
SC
Enumeration date
09/06/2017
Last updated
09/06/2017
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