# JUSTUS DENTAL, HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JUSTUS COMMUNITY PERPETUALIZATION PROJECT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275308207
- **Legal business name:** JUSTUS COMMUNITY PERPETUALIZATION PROJECT
- **Authorized official:** DR. LATHONIA BENNETT DDS (DIRECTOR)
- **Authorized official phone:** (912) 996-3303

## Contact information

- **Practice address:** 3924 US HIGHWAY 521, ANDREWS, SC 29510-5706
- **Practice address phone:** (843) 800-0087
- **Mailing address:** PO BOX 1010, KINGSTREE, SC 29556-1010
- **Mailing address phone:** (912) 996-3303
- **Mailing address fax:** (866) 379-9998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |
| 292200000X | Dental Laboratory | — | NULL | — |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 05/28/2025