Organization
DS DENTAL, LLC
Active
Other names
Carolina Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY JANE SPIGUZZA (VICE PRESIDENT)
(765) 220-0620
Entity
Organization
Contact information
Practice address
4004 BAYBORO ST., LORIS, SC 29569
(843) 756-2273
(843) 756-0242
Mailing address
PO BOX 369, LORIS, SC 29569
(843) 756-2273
(843) 756-0242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9575
—
SC
Enumeration date
01/26/2006
Last updated
11/16/2018
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