| Coastal Orthodontics | |
|
1600 Burnside St Suite 105 Beaufort SC 29902-3779 | |
| (843) 379-9200 | |
| Not Available |
| Full Name | Coastal Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1600 Burnside St, Beaufort, South Carolina |
| Authorized Official Name and Position | Malloy Groves Scott (OFFICER) |
| Authorized Official Contact | 8433799200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Orthodontics 1600 Burnside St Suite 105 Beaufort SC 29902-3779 Ph: () - | Coastal Orthodontics 1600 Burnside St Suite 105 Beaufort SC 29902-3779 Ph: (843) 379-9200 |
| NPI Number | 1013273549 |
|---|---|
| Provider Enumeration Date | 04/10/2012 |
| Last Update Date | 02/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013273549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4410 (South Carolina) | Primary |
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