| Ds Dental, Llc | |
|
4004 Bayboro St. Loris SC 29569 | |
| (843) 756-2273 | |
| (843) 756-0242 |
| Full Name | Ds Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 4004 Bayboro St., Loris, South Carolina |
| Authorized Official Name and Position | Lacey Jane Spiguzza (VICE PRESIDENT) |
| Authorized Official Contact | 7652200620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ds Dental, Llc Po Box 369 Loris SC 29569 Ph: (843) 756-2273 | Ds Dental, Llc 4004 Bayboro St. Loris SC 29569 Ph: (843) 756-2273 |
| NPI Number | 1811968159 |
|---|---|
| Provider Enumeration Date | 01/26/2006 |
| Last Update Date | 11/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811968159 | NPI | - | NPPES |
| ZA9575 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 122300000X | Dentist | (* (Not Available)) | Primary |
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