Individual
KEITH WILLIAM STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1460 JOHN B WHITE SR BLVD STE 1-5, SPARTANBURG, SC 29306-3996
(470) 552-1823
Mailing address
1460 JOHN B WHITE SR BLVD STE 1-5, SPARTANBURG, SC 29306-3996
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2984
SC
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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