Individual
DR. JOHN FRAZIER BOUTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3369 PELHAM RD, GREENVILLE, SC 29615-4105
(864) 297-6365
Mailing address
3369 PELHAM RD, GREENVILLE, SC 29615-4105
(864) 297-6365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7099
LA
122300000X
Dentist
Primary
9855
SC
Other
Enumeration date
06/11/2020
Last updated
01/20/2022
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