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Organization
SURFSIDE DENTAL LLC
Active
Organization
SURFSIDE DENTAL LLC
Active
Other names
SURFSIDE FAMILY DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT J WILLIS (MEMBER)
(843) 652-0011
Entity
Organization
Contact information
Practice address
1665 GLENNS BAY RD, SURFSIDE BEACH, SC 29575-4836
(843) 215-6080
(888) 636-7841
Mailing address
11919 PLAZA DR, MURRELLS INLET, SC 29576-9356
(843) 652-0011
(888) 636-7841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1693
SC
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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