Organization
SPARKLE DENTAL CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMERON JULIUS BANKS PSY.D (PRESIDENT)
(843) 833-3555
Entity
Organization
Contact information
Practice address
8848 HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29588-7739
(843) 650-6700
Mailing address
PO BOX 1861, GEORGETOWN, SC 29442-1861
(843) 833-3555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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