# KEVIN NIETZER DMD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Anderson Pediatric Dentistry PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265942700
- **Authorized official:** DR. KEVIN NIETZER DMD (OWNER/PEDIATRIC DENTIST)
- **Authorized official phone:** (617) 997-5902

## Contact information

- **Practice address:** 198 MUTUAL DR, ANDERSON, SC 29621-1767
- **Practice address phone:** (864) 760-1440
- **Practice address fax:** (864) 226-9709
- **Mailing address:** 198 MUTUAL DR, ANDERSON, SC 29621-1767
- **Mailing address phone:** (864) 760-1440
- **Mailing address fax:** (864) 226-9709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 7003 | SC | Yes |

## Other

- **Enumeration date:** 10/11/2017
- **Last updated:** 10/11/2017