| Myrtle Beach Dental Associates Pa | |
|
8151 Rourk St 82nd Pkwy Myrtle Beach SC 29572 | |
| (843) 449-4372 | |
| (843) 497-9853 |
| Full Name | Myrtle Beach Dental Associates Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8151 Rourk St 82nd Pkwy, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | John Edward Iseman (OWNER PRESIDENT) |
| Authorized Official Contact | 8434494372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Myrtle Beach Dental Associates Pa 8151 Rourk St 82nd Pkwy Myrtle Beach SC 29572 Ph: (843) 449-4372 | Myrtle Beach Dental Associates Pa 8151 Rourk St 82nd Pkwy Myrtle Beach SC 29572 Ph: (843) 449-4372 |
| NPI Number | 1558470450 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558470450 | NPI | - | NPPES |
| ZA9684 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3771 (South Carolina) | Secondary |
| 1223G0001X | Dentist - General Practice | 2995 (South Carolina) | Primary |
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