| Tidal Creek Dental Llc | |
|
1127 Queensborough Blvd Suite 107 Mount Pleasant SC 29464-5431 | |
| (603) 321-9029 | |
| Not Available |
| Full Name | Tidal Creek Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1127 Queensborough Blvd, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | George A Gaillardetz (OWNER) |
| Authorized Official Contact | 6033219029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidal Creek Dental Llc 1127 Queensborough Blvd Suite 107 Mount Pleasant SC 29464-5431 Ph: (603) 321-9029 | Tidal Creek Dental Llc 1127 Queensborough Blvd Suite 107 Mount Pleasant SC 29464-5431 Ph: (603) 321-9029 |
| NPI Number | 1568996585 |
|---|---|
| Provider Enumeration Date | 04/17/2017 |
| Last Update Date | 04/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568996585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8715 (South Carolina) | Primary |
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