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Organization

DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC

Active
Parent organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Other names
Smiles at Carolina Forest
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF SOUTH CAROLINA, PC
Authorized official
HEATHER PRUEMER (CREDENTIALING)
(217) 540-8434
Entity
Organization

Contact information

Practice address
100 DEBO DR UNIT 110, MYRTLE BEACH, SC 29579-4921
(844) 514-4569
Mailing address
100 DEBO DR UNIT 110, MYRTLE BEACH, SC 29579-4921

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
03/31/2015
Last updated
03/31/2015
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