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Organization
DS DENTAL, LLC
Active
Organization
DS DENTAL, LLC
Active
Other names
Carolina Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY JANE SPIGUZZA (VICE PRESIDENT)
(765) 220-0620
Entity
Organization
Contact information
Practice address
4004 BAYBORO ST., LORIS, SC 29569
(843) 756-2273
(843) 756-0242
Mailing address
PO BOX 369, LORIS, SC 29569
(843) 756-2273
(843) 756-0242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9575
—
SC
Enumeration date
01/26/2006
Last updated
11/16/2018
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