Organization
MAGNOLIA FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW RYAN SPERBER DDS (OWNER)
(843) 900-4428
Entity
Organization
Contact information
Practice address
2015 2ND AVE STE 201, SUMMERVILLE, SC 29486-7889
(516) 521-3012
Mailing address
2015 2ND AVE STE 201, SUMMERVILLE, SC 29486-7889
(843) 900-4428
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
06/27/2021
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