Individual
VIVIANA ANGELINA OJEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9608 SC-707, MYRTLE BEACH, SC 29588
(843) 808-6025
Mailing address
9608 SC-707, MYRTLE BEACH, SC 29588
(203) 446-6627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11154
SC
1223G0001X
General Practice Dentistry
12308
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235893
—
CT
Enumeration date
11/06/2018
Last updated
07/02/2025
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