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General NPI Number Information
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NPI Number | 1598909467
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Entity Type | Organization
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Legal Business Name | KENNETH C. DOBSON DMD INC.
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 241 STORK WAY
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City | SENECA
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State | SC
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Zip | 29678-1039
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Country | US
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Telephone | 864-888-3102
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Fax | 864-888-3124
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Provider Business Mailing Address
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Address Line | 241 STORK WAY
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City | SENECA
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State | SC
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Zip | 29678-1039
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Country | US
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Telephone | 864-888-3102
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Fax | 864-888-3124
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. KENNETH CHARLES DOBSON
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Credential | D.M.D.
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Telephone | 864-888-3102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1585
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2486
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License Number State | SC
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