Organization
DENTAL PROFESSIONALS OF SOUTH CAROLINA, P.C.
Active
Parent organization
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Other names
Coastal Cosmetic Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONAL OF SOUTH CAROLINA, P.C.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
1247 HIGHWAY 17, LITTLE RIVER, SC 29566-9211
(843) 249-4092
Mailing address
PO BOX 635, LITTLE RIVER, SC 29566-0635
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/01/2024
Last updated
04/08/2024
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