| Waccamaw Pediatric Dental Care, Llc | |
|
158 Waccamaw Medical Park Ct Conway SC 29526-8965 | |
| (843) 347-5654 | |
| (843) 347-3013 |
| Full Name | Waccamaw Pediatric Dental Care, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 158 Waccamaw Medical Park Ct, Conway, South Carolina |
| Authorized Official Name and Position | Deirdre Sams Williams (PEDIATRIC DENTIST) |
| Authorized Official Contact | 8433475654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waccamaw Pediatric Dental Care, Llc 158 Waccamaw Medical Park Ct Conway SC 29526-8965 Ph: (843) 347-5654 | Waccamaw Pediatric Dental Care, Llc 158 Waccamaw Medical Park Ct Conway SC 29526-8965 Ph: (843) 347-5654 |
| NPI Number | 1225194558 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225194558 | NPI | - | NPPES |
| ZA9510 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3484 (South Carolina) | Primary |
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