Organization
BERKELEY PROSTHETIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC BRANDON ROBERTS (LAB MANAGER)
(843) 761-6411
Entity
Organization
Contact information
Practice address
216 CAROLINA AVE, MONCKS CORNER, SC 29461-3785
(843) 761-6411
(843) 719-1189
Mailing address
216 CAROLINA AVE, MONCKS CORNER, SC 29461-3785
(843) 761-6411
(843) 719-1189
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
555
SC
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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