| Coastal Cosmetic Dental Associates, | |
|
1247 Highway 17 Little River SC 29566-9211 | |
| (843) 249-4092 | |
| (843) 249-1638 |
| Full Name | Coastal Cosmetic Dental Associates, |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1247 Highway 17, Little River, South Carolina |
| Authorized Official Name and Position | Patty R Van Wie (PRES) |
| Authorized Official Contact | 8432494092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Cosmetic Dental Associates, Po Box 635 Little River SC 29566-0635 Ph: (843) 249-4092 | Coastal Cosmetic Dental Associates, 1247 Highway 17 Little River SC 29566-9211 Ph: (843) 249-4092 |
| NPI Number | 1437284270 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437284270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2537 (South Carolina) | Primary |
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