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Organization

COASTAL KIDS DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ISABEL GHOWANLU DRIGGERS DMD (DENTIST/OWNER)
(843) 478-8437
Entity
Organization

Contact information

Practice address
1931 STRATHMOOR BLVD, LOUISVILLE, KY 40205-2525
(843) 478-8437
Mailing address
1000 TANNER FORD BLVD, SUITE 370, HANAHAN, SC 29410-4707
(843) 478-8437

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
SC3889
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZX3889
SC
Enumeration date
03/06/2009
Last updated
04/01/2009
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