Organization
SHINDA LLC
Active
Other names
Osteognathic Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT MCMILLAN JR. DDS (MANAGER)
(803) 531-0750
Entity
Organization
Contact information
Practice address
943 JOHN C CALHOUN DR, ORANGEBURG, SC 29115
(803) 662-9398
Mailing address
943 JOHN C CALHOUN DR, ORANGEBURG, SC 29115-6763
(803) 937-4128
(880) 937-4128
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9197
—
SC
Enumeration date
07/11/2008
Last updated
01/31/2025
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