NPI 1124417522 · live from the CMS NPI Registry
Coastal Kids Dental & Braces
Dentist, Orthodontics and Dentofacial Orthopedics in North Charleston, SC. National Provider Identifier 1124417522, active.
NPI record
| NPI | 1124417522 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 8600 Dorchester Rd, Ste 104, North Charleston, SC 29420 |
| Practice phone | 843-818-5437 |
| Mailing address | 808 Wappoo Rd, Charleston, SC 29407 |
| Enumerated | January 22, 2015 |
| Last updated | January 22, 2015 |
| Authorized official | Jacob Driggers, Coo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | 4209 (SC) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 4476 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.