# SOUTHERN CHARM PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073162053
- **Authorized official:** ANGELICA WONG DDS (OWNER)
- **Authorized official phone:** (562) 441-4757

## Contact information

- **Practice address:** 2021 BRIDGEMILL RD., SUITE 108, INDIAN LAND, SC 29707-2817
- **Practice address phone:** (562) 441-4757
- **Mailing address:** 1305 WAYNEWOOD DR, WAXHAW, NC 28173-6907
- **Mailing address phone:** (562) 441-4757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2019
- **Last updated:** 09/11/2019