| Ds Dental Llc | |
|
4004 Bayboro St Loris SC 29569-2867 | |
| (765) 220-0620 | |
| Not Available |
| Full Name | Ds Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4004 Bayboro St, Loris, South Carolina |
| Authorized Official Name and Position | Lacey Jane Spiguzza (CFO) |
| Authorized Official Contact | 7652200620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ds Dental Llc 5725 Peregrine Pl Apt 101 Fort Wayne IN 46804-0010 Ph: (765) 220-0620 | Ds Dental Llc 4004 Bayboro St Loris SC 29569-2867 Ph: (765) 220-0620 |
| NPI Number | 1417422064 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417422064 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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