Individual
DR. DIANE WATT JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
110A HOSPITAL DR, SIMPSONVILLE, SC 29681-3226
(864) 757-8820
Mailing address
110 VILLA RD, GREENVILLE, SC 29615-3010
(864) 282-1935
(864) 282-1955
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7146
SC
122300000X
Dentist
Primary
788
SC
1223G0001X
General Practice Dentistry
8734
KY
Other
Enumeration date
10/05/2009
Last updated
05/28/2015
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