NPI 1114091600

Russell A. Boatwright, D.M.D., P.C.

Organisation General Practice Dentistry Conway, SC

Practice location

Address: 1603 10th Ave, Conway, SC 29526-4111
Phone: (843) 248-2705
Fax: (843) 248-4202
Mailing address: PO Box 1077, Conway, SC 29528-1077

Authorised official

Name: Russell a Boatwright
Title: President
Phone: (843) 248-2705

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 2775 (SC)

Other Dentist providers in South Carolina →

Registry record

NPI: 1114091600
Entity type: Organization
NPI issued: 17 Nov 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.