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Organization
COASTAL KIDS DENTAL PA
Active
Organization
COASTAL KIDS DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISABEL DRIGGERS (OWNER)
(843) 818-5437
Entity
Organization
Contact information
Practice address
8600 DORCHESTER RD, SUITE 104, NORTH CHARLESTON, SC 29420-7382
(843) 818-5437
Mailing address
1000 TANNER FORD BLVD, SUITE 370, HANAHAN, SC 29410-4707
(843) 818-5437
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3889
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4476
SC
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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