| Happy Teeth Happy Kids, Llc | |
|
3074 Deville St Myrtle Beach SC 29577-1569 | |
| (843) 839-4554 | |
| (843) 839-4043 |
| Full Name | Happy Teeth Happy Kids, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3074 Deville St, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Marlene Mendez (OWNER) |
| Authorized Official Contact | 8438394554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Happy Teeth Happy Kids, Llc 3074 Deville St Myrtle Beach SC 29577-1569 Ph: (843) 839-4554 | Happy Teeth Happy Kids, Llc 3074 Deville St Myrtle Beach SC 29577-1569 Ph: (843) 839-4554 |
| NPI Number | 1225410558 |
|---|---|
| Provider Enumeration Date | 06/23/2015 |
| Last Update Date | 06/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225410558 | NPI | - | NPPES |
| 1144462698 | Medicaid | SC | |
| 1336337047 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4406 (South Carolina) | Primary |
| 1223P0300X | Dentist - Periodontics | 4429 (South Carolina) | Secondary |
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