Individual
MS. KELLY BIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
100 OLD CHEROKEE RD, SUITE F PMB 14, LEXINGTON, SC 29072-9316
(800) 276-2398
Mailing address
106 TOTEM CT, SUMMERVILLE, SC 29486-1973
(814) 602-8028
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
9406
SC
Other
Enumeration date
08/05/2015
Last updated
07/11/2016
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