Organization
KINGSTREE FAMILY DENTISRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT TYLER WILLIAMS DMD (OWNER)
(843) 819-1524
Entity
Organization
Contact information
Practice address
1200 N LONGSTREET ST, KINGSTREE, SC 29556-2738
(843) 355-5554
Mailing address
325 FOLLY RD, STE 310, CHARLESTON, SC 29412-2507
(843) 737-4437
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6968
SC
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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