Individual
KATELYN NEVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
460 W KILLIAN RD, COLUMBIA, SC 29203
(803) 814-0102
Mailing address
422 HAWKEYE CT, COLUMBIA, SC 29206-5094
(219) 929-7848
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9194
SC
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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