Organization
KIDS TEETH, LLC
Active
Other names
Wrobleski & MacDonald Pediatric Dental Partnership
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA TORLAY - KURSH (FINANCIAL COORDINATOR)
(843) 216-5879
Entity
Organization
Contact information
Practice address
1130 PROFESSIONAL LN, MOUNT PLEASANT, SC 29466-7193
(843) 216-5879
(843) 310-3771
Mailing address
1130 PROFESSIONAL LN, MT PLEASANT, SC 29466-7193
(843) 216-5879
(843) 216-5891
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2085
SC
1223P0221X
Pediatric Dentistry
3863
SC
1223P0221X
Pediatric Dentistry
3881
SC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3030
SC
207L00000X
Anesthesiology Physician
7171
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z20850
—
SC
05
—
ZA9866
—
SC
05
—
ZX3881
—
SC
Enumeration date
04/19/2006
Last updated
08/01/2024
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