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Organization

KEENAN W. SMITH, D.M.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEENAN WEBSTER SMITH D.M.D. (PRESIDENT)
(864) 676-0825
Entity
Organization

Contact information

Practice address
40 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 676-0825
(864) 676-9859
Mailing address
40 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 676-0825
(864) 676-9859

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4348
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX4348
SC
Enumeration date
04/30/2009
Last updated
04/30/2009
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