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Organization
MYRTLE BEACH DENTAL ASSOCIATES PA
Active
Organization
MYRTLE BEACH DENTAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EDWARD ISEMAN DDS (OWNER PRESIDENT)
(843) 449-4372
Entity
Organization
Contact information
Practice address
8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
(843) 449-4372
(843) 497-9853
Mailing address
8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
(843) 449-4372
(843) 497-9853
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2995
SC
1223G0001X
General Practice Dentistry
3771
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9684
—
SC
Enumeration date
08/30/2006
Last updated
08/22/2020
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