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Organization

HAPPY TEETH HAPPY KIDS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARLENE MENDEZ DMD (OWNER)
(843) 839-4554
Entity
Organization

Contact information

Practice address
3074 DEVILLE ST, MYRTLE BEACH, SC 29577-1569
(843) 839-4554
(843) 839-4043
Mailing address
3074 DEVILLE ST, MYRTLE BEACH, SC 29577-1569
(843) 839-4554
(843) 839-4043

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4406
SC
1223P0300X
Periodontics
4429
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144462698
SC
05
1336337047
SC
Enumeration date
06/23/2015
Last updated
06/23/2015
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