Organization
SOUTHERN OAK DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK GONG (OWNER)
(206) 371-2516
Entity
Organization
Contact information
Practice address
2676 CHURCH ST UNIT A, CONWAY, SC 29526-4471
(843) 331-3237
Mailing address
4921 CENTRE POINTE DR STE 201, N CHARLESTON, SC 29418-6997
(843) 909-1299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
01/30/2020
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