| Latta Smiles | |
|
203 S Marion St Latta SC 29565-1522 | |
| (843) 752-7655 | |
| (843) 752-4500 |
| Full Name | Latta Smiles |
|---|---|
| Speciality | Dentist |
| Location | 203 S Marion St, Latta, South Carolina |
| Authorized Official Name and Position | Raeford Lee Clanton (OWNER) |
| Authorized Official Contact | 8437527655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Latta Smiles 203 S Marion St Latta SC 29565-1522 Ph: (843) 752-7655 | Latta Smiles 203 S Marion St Latta SC 29565-1522 Ph: (843) 752-7655 |
| NPI Number | 1700082930 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700082930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1920 (South Carolina) | Primary |
Latta Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 S Marion St, Latta, SC 29565 Phone: 843-752-7655 Fax: 843-752-4500 |