Organization
CAROLINA PARK FAMILY DENTISTRY LLC
Active
Other names
Carolina Park Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW BELLEBAUM DMD (OWNER)
(843) 654-1918
Entity
Organization
Contact information
Practice address
3520 PARK AVENUE BLVD., SUITE 100, MOUNT PLEASANT, SC 29466-2946
(843) 654-1918
(843) 654-1917
Mailing address
3520 PARK AVENUE BLVD., SUITE 100, MOUNT PLEASANT, SC 29466-7567
(843) 654-1918
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
09/14/2020
Last updated
03/03/2021
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