| Marshlands Family Dentistry | |
|
1090 Ribaut Rd Beaufort SC 29902-5437 | |
| (843) 521-4344 | |
| (843) 521-1804 |
| Full Name | Marshlands Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1090 Ribaut Rd, Beaufort, South Carolina |
| Authorized Official Name and Position | John David Southerland Wise (GENERAL DENTIST) |
| Authorized Official Contact | 8435214344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marshlands Family Dentistry 1090 Ribaut Rd Beaufort SC 29902-5437 Ph: (843) 521-4344 | Marshlands Family Dentistry 1090 Ribaut Rd Beaufort SC 29902-5437 Ph: (843) 521-4344 |
| NPI Number | 1780184036 |
|---|---|
| Provider Enumeration Date | 02/13/2018 |
| Last Update Date | 02/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780184036 | NPI | - | NPPES |
| ZX4601 | Medicaid | SC | |
| 1134233935 | Other | SC | NPI |
| 1548499635 | Other | SC | NPI |
| Z17777 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4601 (South Carolina) | Primary |
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