| Keenan W. Smith, D.m.d., P.a. | |
|
40 Creekview Ct Greenville SC 29615-4800 | |
| (864) 676-0825 | |
| (864) 676-9859 |
| Full Name | Keenan W. Smith, D.m.d., P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 40 Creekview Ct, Greenville, South Carolina |
| Authorized Official Name and Position | Keenan Webster Smith (PRESIDENT) |
| Authorized Official Contact | 8646760825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keenan W. Smith, D.m.d., P.a. 40 Creekview Ct Greenville SC 29615-4800 Ph: (864) 676-0825 | Keenan W. Smith, D.m.d., P.a. 40 Creekview Ct Greenville SC 29615-4800 Ph: (864) 676-0825 |
| NPI Number | 1073757381 |
|---|---|
| Provider Enumeration Date | 04/30/2009 |
| Last Update Date | 04/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073757381 | NPI | - | NPPES |
| ZX4348 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4348 (South Carolina) | Primary |
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