Organization
SOUTHERN SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT JULIUS BEAVERS D.D.S. (MEMBER)
(843) 871-9070
Entity
Organization
Contact information
Practice address
298 OLD TROLLEY RD, SUMMERVILLE, SC 29485-4929
(843) 871-9070
(843) 871-9111
Mailing address
298 OLD TROLLEY RD, SUMMERVILLE, SC 29485-4929
(843) 871-9070
(843) 871-9111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2560
SC
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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