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SURFSIDE DENTAL LLC NPI 1316216500


NPI Information

NPI: 1316216500
Provider Name: SURFSIDE DENTAL LLC

Doing Business As: SURFSIDE FAMILY DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1665 GLENNS BAY RD
SURFSIDE BEACH, SC
ZIP 29575
Phone: (843) 215-6080
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SURFSIDE DENTAL LLC is a general practice dentist in Surfside Beach, SC. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SURFSIDE DENTAL LLC NPI is 1316216500. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Surfside Family Dentistry.

The provider's business location address is:

1665 GLENNS BAY RD
SURFSIDE BEACH, SC
ZIP 29575-836
Phone: (843) 215-6080
Fax: (888) 636-7841

The provider's authorized official is Scott J Willis .
The authorized official title is Member and has the following contact phone number (843) 652-0011.

The enumeration date for this NPI number is 12/19/2011 and was last updated on 12/19/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice1693SOUTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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