Organization
RIDGELAND SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL BOSTICK JR. (OWNER)
(843) 812-8191
Entity
Organization
Contact information
Practice address
10832 N JACOB SMART BLVD, RIDGELAND, SC 29936
(843) 812-8191
Mailing address
PO BOX 1434, RIDGELAND, SC 29936-2624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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