| Keith W. Street Dmd Llc | |
|
110 Buford Ave Anderson SC 29621-3314 | |
| (864) 224-2526 | |
| Not Available |
| Full Name | Keith W. Street Dmd Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 110 Buford Ave, Anderson, South Carolina |
| Authorized Official Name and Position | Keith William Street (ORTHODONTIST) |
| Authorized Official Contact | 8642242526 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith W. Street Dmd Llc 110 Buford Ave Anderson SC 29621-3314 Ph: (864) 224-2526 | Keith W. Street Dmd Llc 110 Buford Ave Anderson SC 29621-3314 Ph: (864) 224-2526 |
| NPI Number | 1992955249 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 09/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992955249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 2894 SPEC 0391 (South Carolina) | Primary |
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