Organization
SOUTHERN TIDES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLIE A FOUST DA (COACH)
(803) 322-6020
Entity
Organization
Contact information
Practice address
1701 BEAUCASTLE RD STE B, MT PLEASANT, SC 29464-3685
(843) 258-8604
Mailing address
1850 CREST RD, MARYVILLE, TN 37804-4305
(865) 982-1700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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