Organization
BLUE RIDGE ENDODONTICS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH CHARLES CARVER D.M.D., M.S. (PRESIDENT)
(865) 654-1715
Entity
Organization
Contact information
Practice address
101 FINLEY ST STE A, CLEMSON, SC 29631-1583
(864) 654-1715
(864) 654-1730
Mailing address
PO BOX 312, CLEMSON, SC 29633-0312
(864) 654-1715
(864) 654-1730
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3962
SC
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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