Organization
WESTSIDE DENTAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN CUTLER (SECRETARY)
(607) 743-9474
Entity
Organization
Contact information
Practice address
1812 WALLACE SCHOOL RD STE 400, CHARLESTON, SC 29407-4517
(843) 571-4411
Mailing address
296 S MAIN ST STE 300, ALPHARETTA, GA 30009-1973
(607) 743-9474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
Other
Enumeration date
08/17/2021
Last updated
05/12/2022
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