# SEASIDE PEDIATRIC DENTAL ASSOCIATES

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

## Provider details

- **NPI number:** 1578084331
- **Authorized official:** DR. MATTHEW TILLMAN DDS (CO-OWNER)
- **Authorized official phone:** (843) 651-5437

## Contact information

- **Practice address:** 4410 HIGHWAY 17 UNIT B6, MURRELLS INLET, SC 29576
- **Practice address phone:** (423) 741-9078
- **Mailing address:** 4410 HIGHWAY 17 UNIT B6, MURRELLS INLET, SC 29576-6434
- **Mailing address phone:** (423) 741-9078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/03/2017
- **Last updated:** 07/21/2022