| Village Family Dental | |
|
3012 Newcastle Loop Myrtle Beach SC 29588-4501 | |
| (843) 215-2599 | |
| Not Available |
| Full Name | Village Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3012 Newcastle Loop, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | John Michael Rearden (OWNER/DENTIST) |
| Authorized Official Contact | 8432152599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Family Dental 3012 Newcastle Loop Myrtle Beach SC 29588-4501 Ph: (843) 215-2599 | Village Family Dental 3012 Newcastle Loop Myrtle Beach SC 29588-4501 Ph: (843) 215-2599 |
| NPI Number | 1952583924 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 12/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952583924 | NPI | - | NPPES |
| ZA9719 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 90157 (South Carolina) | Primary |
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