Organization
MCCLELLANVILLE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA VARADI DMD (DENTIST/OWNER)
(843) 345-5870
Entity
Organization
Contact information
Practice address
832 PINCKNEY ST, MC CLELLANVILLE, SC 29458-9762
(843) 887-3763
Mailing address
PO BOX 220, MC CLELLANVILLE, SC 29458-0220
(843) 887-3763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9472
—
SC
Enumeration date
01/14/2020
Last updated
01/14/2020
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