# MYRTLE BEACH DENTAL ASSOCIATES PA

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

## Provider details

- **NPI number:** 1558470450
- **Authorized official:** DR. JOHN EDWARD ISEMAN DDS (OWNER PRESIDENT)
- **Authorized official phone:** (843) 449-4372

## Contact information

- **Practice address:** 8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
- **Practice address phone:** (843) 449-4372
- **Practice address fax:** (843) 497-9853
- **Mailing address:** 8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
- **Mailing address phone:** (843) 449-4372
- **Mailing address fax:** (843) 497-9853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2995 | SC | Yes |
| 1223G0001X | General Practice Dentistry | 3771 | SC | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZA9684 | — | SC |