Heritage Dental Llc | |
9598 Palmetto Commerce Parkway Ladson SC 29456 | |
(860) 573-5681 | |
Not Available |
Full Name | Heritage Dental Llc |
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Speciality | Clinic/center - Dental |
Location | 9598 Palmetto Commerce Parkway, Ladson, South Carolina |
Authorized Official Name and Position | Robert Alan Breault (PRESIDENT) |
Authorized Official Contact | 8605735681 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Heritage Dental Llc 9598 Palmetto Commerce Parkway Ladson SC 29456 Ph: () - | Heritage Dental Llc 9598 Palmetto Commerce Parkway Ladson SC 29456 Ph: (860) 573-5681 |
NPI Number | 1467982728 |
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Provider Enumeration Date | 06/19/2017 |
Last Update Date | 06/20/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467982728 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 8323 (South Carolina) | Primary |
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