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418 Main St Ste C North Myrtle Beach SC 29582-3041 | |
(843) 249-7736 | |
(843) 249-3259 |
Full Name | |
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Speciality | Dentist |
Location | 418 Main St Ste C, North Myrtle Beach, South Carolina |
Authorized Official Name and Position | Craig Lee Milburn (OWNER) |
Authorized Official Contact | 8432497736 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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418 Main St Ste C North Myrtle Beach SC 29582-3041 Ph: (843) 249-7736 | 418 Main St Ste C North Myrtle Beach SC 29582-3041 Ph: (843) 249-7736 |
NPI Number | 1780008110 |
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Provider Enumeration Date | 02/05/2014 |
Last Update Date | 02/05/2014 |
Identifier | Type | State | Issuer |
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1780008110 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (South Carolina) | 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 | |