Stephenson, John Mckethan

Stephenson, John Mckethan is an individual health care provider with primary practice located at 402 Dicey Ford Rd Ste E, Camden SC 29020. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Periodontics. Dental Providers / Dentist is his primary health care specialty. Stephenson, John Mckethan can be contacted via phone (803) 425-1644.

Contact Information

Primary practice address
402 Dicey Ford Rd Ste E Camden SC 29020
Phone: (803) 425-1644
Fax: (803) 425-1640
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1902 South Carolina
Dental Providers / Periodontics 1223P0300X 288 South Carolina

Profile Details

NPI number 1598775736
LBN Legal business name Stephenson, John Mckethan
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598775736 NPPES
South Carolina MEDICAID Z19025

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