Organization
LITTLE WAVES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI PORRAS DMD (PEDIATRIC DENTIST)
(954) 383-3893
Entity
Organization
Contact information
Practice address
4603 OLEANDER DRIVE, UNIT 3,4,5, MYRTLE BEACH, SC 29577
(843) 353-3319
(843) 353-3238
Mailing address
584 STARLIT WAY, MYRTLE BEACH, SC 29579-4322
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
05/30/2024
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