Individual
BETHANY PAIGE LEEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1136 FOLLY RD, CHARLESTON, SC 29412-4104
(843) 225-7171
Mailing address
1136 FOLLY RD, CHARLESTON, SC 29412-4104
(443) 293-2025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10282
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2021
Last updated
07/21/2022
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