Organization
GRAND STRAND PEDIATRIC DENTISTRY
Active
Parent organization
GRAND STRAND PEDIATRIC DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAND STRAND PEDIATRIC DENTISTRY
Authorized official
DR. WINONA M NEWMAN DMD (OWNER)
(843) 294-5437
Entity
Organization
Contact information
Practice address
3112 DICK POND ROAD, MYRTLE BEACH, SC 29588-4833
(843) 294-5437
(843) 294-5440
Mailing address
3112 DICK POND ROAD, MYRTLE BEACH, SC 29588-4833
(843) 294-5437
(843) 294-5440
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
3125
SC
1223P0221X
Pediatric Dentistry
Primary
3125SC
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9590
—
SC
Enumeration date
05/14/2007
Last updated
03/03/2010
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