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Organization

SPACEY'S TOOTH SHOPPE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EUGENE DENNIS SPACEY DMD (PRESIDENT)
(843) 559-3135
Entity
Organization

Contact information

Practice address
3201 MAYBANK HWY, JOHNS ISLAND, SC 29455-4817
(843) 559-3135
Mailing address
3201 MAYBANK HWY, JOHNS ISLAND, SC 29455-4817
(843) 559-3135

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC2958
SC

Other

Enumeration date
03/21/2007
Last updated
08/22/2020
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