Organization
NORTH CHARLESTON DENTAL OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH JONATHAN MELENDEZ (DEVELOPMENT DIRECTOR)
(843) 740-7114
Entity
Organization
Contact information
Practice address
3625 AZALEA DR, NORTH CHARLESTON, SC 29405-7610
(843) 740-7114
Mailing address
3625 AZALEA DR, NORTH CHARLESTON, SC 29405-7610
(843) 740-7114
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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