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Organization
CAROLINA PARK FAMILY DENTISTRY LLC
Active
Organization
CAROLINA PARK FAMILY DENTISTRY LLC
Active
Other names
Carolina Park Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW BELLEBAUM DMD (OWNER)
(843) 654-1918
Entity
Organization
Contact information
Practice address
3520 PARK AVENUE BLVD., SUITE 100, MOUNT PLEASANT, SC 29466-2946
(843) 654-1918
(843) 654-1917
Mailing address
3520 PARK AVENUE BLVD., SUITE 100, MOUNT PLEASANT, SC 29466-7567
(843) 654-1918
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
09/14/2020
Last updated
03/03/2021
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