Organization
SEA ISLAND FAMILY DENISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CAGLE III DMD (OWNER)
(843) 884-4340
Entity
Organization
Contact information
Practice address
902 COLEMAN BLVD, MOUNT PLEASANT, SC 29464-4046
(843) 884-4340
(843) 884-1703
Mailing address
902 COLEMAN BLVD, MOUNT PLEASANT, SC 29464-4046
(843) 884-4340
(843) 884-1703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2564
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9805
—
SC
Enumeration date
10/13/2006
Last updated
08/22/2020
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