Organization
NEW SMILE SHOPPE LLC
Active
Parent organization
THE DENTAL IMPLANT CENTRE
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE DENTAL IMPLANT CENTRE
Authorized official
DR. JOSEPH C. GILLESPIE DDS (PROVIDER AND OWNER)
(843) 314-3006
Entity
Organization
Contact information
Practice address
1051 JOHNNIE DODDS BLVD, MOUNT PLEASANT, SC 29464
(843) 388-9690
(843) 388-9703
Mailing address
38 BLACKGUM ROAD, SUITE G, PAWLEYS ISL, SC 29585
(843) 314-3006
(843) 314-8037
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144498213
DENTISTRY
SC
Enumeration date
05/04/2021
Last updated
05/04/2021
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