Provider Demographics
NPI:1730593856
Name:CARNES, KATHRYN CAMILLE (DMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:CAMILLE
Last Name:CARNES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-0451
Mailing Address - Country:US
Mailing Address - Phone:864-630-5198
Mailing Address - Fax:
Practice Address - Street 1:108 BURTON ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5400
Practice Address - Country:US
Practice Address - Phone:864-576-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice