Organization
J KEITH BAGWELL DMD PA
Active
Other names
riverside dental care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES K BAGWELL (PRESIDENT)
(864) 877-2541
Entity
Organization
Contact information
Practice address
1275 S SUBER RD, GREER, SC 29650-0940
(864) 877-2541
Mailing address
1275 S SUBER RD, GREER, SC 29650-0940
(864) 877-2541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3413
SC
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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