Individual
DR. KEITH A FINCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
101 E JACKSON ST, DILLON, SC 29536-2421
(843) 774-7762
(843) 774-7920
Mailing address
348 RABBIT ISLAND RD, LAKE VIEW, SC 29563-5362
(843) 759-0175
(843) 774-7920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3210
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8992681
—
NC
05
—
Z32108
—
SC
Enumeration date
05/15/2007
Last updated
08/18/2016
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