| Heritage Dental Llc | |
|
9598 Palmetto Commerce Parkway Ladson SC 29456 | |
| (860) 573-5681 | |
| Not Available |
| Full Name | Heritage Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9598 Palmetto Commerce Parkway, Ladson, South Carolina |
| Authorized Official Name and Position | Robert Alan Breault (PRESIDENT) |
| Authorized Official Contact | 8605735681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Dental Llc 9598 Palmetto Commerce Parkway Ladson SC 29456 Ph: () - | Heritage Dental Llc 9598 Palmetto Commerce Parkway Ladson SC 29456 Ph: (860) 573-5681 |
| NPI Number | 1467982728 |
|---|---|
| Provider Enumeration Date | 06/19/2017 |
| Last Update Date | 06/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467982728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8323 (South Carolina) | Primary |
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