NPI 1962847814 · live from the CMS NPI Registry
Coastal Kids Dental PA
Dentist, Pediatric Dentistry in North Charleston, SC. National Provider Identifier 1962847814, active.
NPI record
| NPI | 1962847814 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Pediatric Dentistry 1223P0221X |
| Practice location | 8600 Dorchester Rd, Suite 104, North Charleston, SC 29420 |
| Practice phone | 843-818-5437 |
| Mailing address | 1000 Tanner Ford Blvd, Suite 370, Hanahan, SC 29410 |
| Enumerated | May 6, 2013 |
| Last updated | May 6, 2013 |
| Authorized official | Isabel Driggers, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | 4476 (SC) |
| Dentist, Pediatric Dentistry primary | 1223P0221X | 3889 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.