| |
1586 Hwy 17n North Myrtle Beach SC 29582 | |
(843) 292-4238 | |
Not Available |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 1586 Hwy 17n, North Myrtle Beach, South Carolina |
Authorized Official Name and Position | Kendra Walker (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 2175408312 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1586 Hwy 17n North Myrtle Beach SC 29582 Ph: () - | 1586 Hwy 17n North Myrtle Beach SC 29582 Ph: (843) 292-4238 |
NPI Number | 1306248422 |
---|---|
Provider Enumeration Date | 09/19/2014 |
Last Update Date | 09/19/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306248422 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Riesenberg Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 512 Highway 17 N, North Myrtle Beach, SC 29582 Phone: 843-580-1917 | |