Organization
D. CALVIN RILEY JR. DMD PA
Active
Other names
Crescent Beach Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DON CALVIN RILEY JR. (DENTIST OWNER)
(843) 272-1121
Entity
Organization
Contact information
Practice address
602 17TH AVE SO, NORTH MYRTLE BEACH, SC 29582
(843) 272-1121
(843) 272-9976
Mailing address
602 17TH AVE SO, NORTH MYRTLE BEACH, SC 29582
(843) 272-1121
(843) 272-9976
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2681
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9478
—
SC
05
—
ZZ2681
—
SC
Enumeration date
05/26/2006
Last updated
08/12/2008
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