Organization
CAROLINA ORTHODONTICS AND PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS P LEITE DMD, MS (OWNER/PRESIDENT)
(843) 270-6473
Entity
Organization
Contact information
Practice address
921 LONGTOWN RD STE B, COLUMBIA, SC 29229-9498
(803) 661-8468
Mailing address
PO BOX 854, MOUNT PLEASANT, SC 29465-0854
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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