| Coastal Palm Orthodontics Llc | |
|
1255 Tadlock Dr Unit B Murrells Inlet SC 29576-7973 | |
| (843) 697-1423 | |
| Not Available |
| Full Name | Coastal Palm Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1255 Tadlock Dr Unit B, Murrells Inlet, South Carolina |
| Authorized Official Name and Position | Russell Blake Mccracken (OWNER) |
| Authorized Official Contact | 8436971423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Palm Orthodontics Llc 25 Old Barge Dr Pawleys Island SC 29585-6345 Ph: () - | Coastal Palm Orthodontics Llc 1255 Tadlock Dr Unit B Murrells Inlet SC 29576-7973 Ph: (843) 697-1423 |
| NPI Number | 1568201192 |
|---|---|
| Provider Enumeration Date | 05/22/2024 |
| Last Update Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568201192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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