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Organization
VILLAGE DENTISTRY, PA
Active
Organization
VILLAGE DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT W HAILE D.M.D. (PRESIDENT)
(843) 768-8376
Entity
Organization
Contact information
Practice address
130 GARDNERS CIR, PMB#131, JOHNS ISLAND, SC 29455-5467
(843) 768-8376
Mailing address
130 GARDNERS CIR, PMB#131, JOHNS ISLAND, SC 29455-5467
(843) 768-8376
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1688
SC
Other
Enumeration date
08/29/2007
Last updated
11/20/2007
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