Organization
GRAND STRAND FAMILY AND ESTHETIC DENTISTRY
Active
Parent organization
GRAND STRAND FAMILY AND ESTHETIC DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAND STRAND FAMILY AND ESTHETIC DENTISTRY
Authorized official
DR. WALTER J MACHOWSKI DMD (PRES)
(843) 293-6606
Entity
Organization
Contact information
Practice address
4884 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-6606
Mailing address
4884 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-6606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2503
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9570
—
SC
Enumeration date
09/20/2007
Last updated
01/28/2008
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