Organization
COASTAL FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN WIGGINS (OFFICE MANAGER)
(843) 881-1418
Entity
Organization
Contact information
Practice address
3098 HIGHWAY 17 N, MOUNT PLEASANT, SC 29466-9315
(843) 881-1418
Mailing address
3098 HIGHWAY 17 N, MOUNT PLEASANT, SC 29466-9315
(843) 881-1418
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3298
SC
1223G0001X
General Practice Dentistry
3539
SC
Other
Enumeration date
07/25/2007
Last updated
03/24/2008
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