Organization
INTERCOASTAL ENDO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C CONARD DMD (PRESIDENT)
(843) 449-4900
Entity
Organization
Contact information
Practice address
4382 OLEANDER DR, MYRTLE BEACH, SC 29577
(843) 449-4900
(843) 449-1658
Mailing address
4382 OLEANDER DR, MYRTLE BEACH, SC 29577
(843) 449-4900
(843) 449-1658
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
4617
SC
Other
Enumeration date
06/06/2014
Last updated
06/07/2018
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