# COASTAL PEDIATRIC DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1780736546
- **Authorized official:** BRANDY L RANEY (OFFICE MANAGER)
- **Authorized official phone:** (843) 671-7336

## Contact information

- **Practice address:** 23 MAIN ST, SUITE 302, HILTON HEAD, SC 29926-1648
- **Practice address phone:** (843) 671-7336
- **Mailing address:** 23 MAIN ST, SUITE 302, HILTON HEAD, SC 29926-1648
- **Mailing address phone:** (843) 671-7336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 4076 | SC | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 08/22/2020