| Sweetgrass Dental Associates Dds, Pc | |
|
4950 Centre Pointe Dr Ste 114 North Charleston SC 29418-6929 | |
| (843) 709-7116 | |
| Not Available |
| Full Name | Sweetgrass Dental Associates Dds, Pc |
|---|---|
| Speciality | Dentist |
| Location | 4950 Centre Pointe Dr Ste 114, North Charleston, South Carolina |
| Authorized Official Name and Position | Shawn Mitchell (OWNER/DENTIST) |
| Authorized Official Contact | 8438236530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweetgrass Dental Associates Dds, Pc 4950 Centre Pointe Dr Ste 114 North Charleston SC 29418-6929 Ph: () - | Sweetgrass Dental Associates Dds, Pc 4950 Centre Pointe Dr Ste 114 North Charleston SC 29418-6929 Ph: (843) 709-7116 |
| NPI Number | 1023661998 |
|---|---|
| Provider Enumeration Date | 07/19/2019 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 8123453594 |
|---|---|
| Medicare Enrollment ID | O20200113000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023661998 | NPI | - | NPPES |
| 1720490063 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Shawn Mitchell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720490063 PECOS PAC ID: 3072899293 Enrollment ID: I20200113000603 |
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