Organization
LEGACY PROSTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOHNSON DMD (OWNER-DENTIST)
(843) 215-4343
Entity
Organization
Contact information
Practice address
3017 NEWCASTLE LOOP, MYRTLE BEACH, SC 29588-4502
(843) 215-4343
Mailing address
3017 NEWCASTLE LOOP, MYRTLE BEACH, SC 29588-4502
(843) 215-4343
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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