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NPI Code Detail

MEDICARE: DR. KEITH WILSON STRAUSBAUGH JR. DMD

MEDICARE:  DR. KEITH WILSON STRAUSBAUGH JR. DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry10698SC

General Provider Information

NPI Number : 1164285680
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH WILSON STRAUSBAUGH JR. DMD
Provider Business Mailing Address
First Line : 4 ROCKINGHAM RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-3619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 CLEVELAND ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-2411
Country : US
Telephone Number : 864-233-1905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2024
Last Update Date : 02/06/2024

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Directions to “ DR. KEITH WILSON STRAUSBAUGH JR. DMD” Practice Location

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