# KIDS TEETH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wrobleski & MacDonald Pediatric Dental Partnership
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053376491
- **Authorized official:** REBECCA TORLAY - KURSH (FINANCIAL COORDINATOR)
- **Authorized official phone:** (843) 216-5879

## Contact information

- **Practice address:** 1130 PROFESSIONAL LN, MOUNT PLEASANT, SC 29466-7193
- **Practice address phone:** (843) 216-5879
- **Practice address fax:** (843) 310-3771
- **Mailing address:** 1130 PROFESSIONAL LN, MT PLEASANT, SC 29466-7193
- **Mailing address phone:** (843) 216-5879
- **Mailing address fax:** (843) 216-5891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 2085 | SC | Yes |
| 1223P0221X | Pediatric Dentistry | 3863 | SC | — |
| 1223P0221X | Pediatric Dentistry | 3881 | SC | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 3030 | SC | — |
| 207L00000X | Anesthesiology Physician | 7171 | SC | — |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 08/01/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | Z20850 | — | SC |
| 05 | — | ZA9866 | — | SC |
| 05 | — | ZX3881 | — | SC |