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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Kilgore, Jr., Jack L. | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1295719201 | [sources] | |||
| Sector | Ind-Lic HC Serv Prov - Dentist | [sources] | |||
| Status | not available | [sources] | |||
| Address | Columbia, SC 29223 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded from South Carolina's Medicaid program.
United States · SCDHHS
For experts: raw data explorer
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