Organization
LAKE BOWEN DENTAL STUDIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KACEY MEDLIN EVATT DMD (OWNER)
(864) 578-9366
Entity
Organization
Contact information
Practice address
1242 PARKSIDE ACORN DR, INMAN, SC 29349-8344
(864) 578-9366
Mailing address
1242 PARKSIDE ACORN DR, INMAN, SC 29349-8344
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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