Organization
WACCAMAW PEDIATRIC DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRE SAMS WILLIAMS DDS (PEDIATRIC DENTIST)
(843) 347-5654
Entity
Organization
Contact information
Practice address
158 WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 347-5654
(843) 347-3013
Mailing address
158 WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 347-5654
(843) 347-3013
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3484
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9510
—
SC
Enumeration date
12/29/2006
Last updated
08/22/2020
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