Organization
MYRTLE BEACH DENTAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EDWARD ISEMAN DDS (OWNER PRESIDENT)
(843) 449-4372
Entity
Organization
Contact information
Practice address
8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
(843) 449-4372
(843) 497-9853
Mailing address
8151 ROURK ST 82ND PKWY, MYRTLE BEACH, SC 29572
(843) 449-4372
(843) 497-9853
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2995
SC
1223G0001X
General Practice Dentistry
3771
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9684
—
SC
Enumeration date
08/30/2006
Last updated
08/22/2020
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