# TEGA CAY FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1174112387
- **Authorized official:** JULIA CORREAL DDS (OWENER)
- **Authorized official phone:** (888) 764-5314

## Contact information

- **Practice address:** 1188 STONECREST BLVD, TEGA CAY, SC 29708-6632
- **Practice address phone:** (888) 764-5314
- **Mailing address:** 1188 STONECREST BLVD, TEGA CAY, SC 29708-6632
- **Mailing address phone:** (888) 764-5314

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/12/2021
- **Last updated:** 01/12/2021