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Organization
BEACH DENTAL ASSOCIATES
Active
Organization
BEACH DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLENE M LUCAS (OFFICE MANAGER)
(843) 692-9313
Entity
Organization
Contact information
Practice address
9654 N KINGS HWY, SUITE N, MYRTLE BEACH, SC 29572-4040
(843) 692-9313
(843) 692-2584
Mailing address
9654 N KINGS HWY, SUITE N, MYRTLE BEACH, SC 29572-4040
(843) 692-9313
(843) 692-2584
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9825
—
SC
Enumeration date
10/22/2007
Last updated
10/22/2007
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