| Anderson Pediatric Dentistry Pa | |
|
198 Mutual Dr Anderson SC 29621-1767 | |
| (864) 760-1440 | |
| (864) 226-9709 |
| Full Name | Anderson Pediatric Dentistry Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 198 Mutual Dr, Anderson, South Carolina |
| Authorized Official Name and Position | Kevin Nietzer (OWNER/PEDIATRIC DENTIST) |
| Authorized Official Contact | 6179975902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anderson Pediatric Dentistry Pa 198 Mutual Dr Anderson SC 29621-1767 Ph: (864) 760-1440 | Anderson Pediatric Dentistry Pa 198 Mutual Dr Anderson SC 29621-1767 Ph: (864) 760-1440 |
| NPI Number | 1265942700 |
|---|---|
| Provider Enumeration Date | 10/11/2017 |
| Last Update Date | 10/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265942700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7003 (South Carolina) | Primary |
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