Organization
DS DENTAL LLC
Active
Other names
Carolina Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY JANE SPIGUZZA (CFO)
(765) 220-0620
Entity
Organization
Contact information
Practice address
4004 BAYBORO ST, LORIS, SC 29569-2867
(765) 220-0620
Mailing address
5725 PEREGRINE PL APT 101, FORT WAYNE, IN 46804-0010
(765) 220-0620
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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