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General NPI Number Information
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NPI Number | 1730220146
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Entity Type | Organization
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Legal Business Name | A. KEITH LETHCO D.M.D.,P.A.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1815 MONTAGUE AVENUE EXT SUITE 4
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City | GREENWOOD
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State | SC
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Zip | 29649-7501
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Country | US
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Telephone | 864-223-2433
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Fax | 864-223-3896
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Provider Business Mailing Address
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Address Line | 1815 MONTAGUE AVENUE EXT SUITE 4
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City | GREENWOOD
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State | SC
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Zip | 29649-7501
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Country | US
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Telephone | 864-223-2433
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Fax | 864-223-3896
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW KEITH LETHCO
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Credential | D.M.D.
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Telephone | 864-223-2433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2737
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License Number State | SC
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