| Dental Wellness Center Of Myrtle Beach, Llc | |
|
1017 Highway 501 Ste 70 Myrtle Beach SC 29577-3820 | |
| (843) 508-8782 | |
| (912) 226-3489 |
| Full Name | Dental Wellness Center Of Myrtle Beach, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1017 Highway 501 Ste 70, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Amanda Ray (FINANCIAL COORDINATOR) |
| Authorized Official Contact | 9129205577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Wellness Center Of Myrtle Beach, Llc Po Box 60339 Savannah GA 31420-0339 Ph: (912) 920-5577 | Dental Wellness Center Of Myrtle Beach, Llc 1017 Highway 501 Ste 70 Myrtle Beach SC 29577-3820 Ph: (843) 508-8782 |
| NPI Number | 1588122097 |
|---|---|
| Provider Enumeration Date | 03/05/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588122097 | NPI | - | NPPES |
| 1497918759 | Other | GA | NPI |
| DN010747 | Other | GA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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