Coastal Kids Dental & Braces

LBN: Coastal Kids Dental,Pa
Coastal Kids Dental & Braces is an health care organization with primary practice located at 118 S Walter St , Walterboro SC 29488-3956. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Pediatric Dentistry is the primary health care specialty. Coastal Kids Dental,Pa can be contacted via phone (843) 818-5437, or through Driggers, Jacob via phone (843) 818-5437.

Contact Information

Primary practice address
118 S Walter St Walterboro SC 29488-3956
Phone: (843) 818-5437
Fax: (843) 725-1594
Website:
Map and Directions
Authorized official contact:
Name: Driggers, Jacob
Phone: (843) 818-5437

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 3889 South Carolina
Dental Providers / Pediatric Dentistry 1223P0221X 3889 South Carolina
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 4476 South Carolina

Profile Details

NPI number 1548659022
LBN Legal business name Coastal Kids Dental,Pa
DBA Doing business as Coastal Kids Dental & Braces
Authorized official Driggers, Jacob
Entity Organization
Organization subpart 1 No
Enumeration date Jan 21st, 2015
Last updated Jan 21st, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548659022 NPPES
South Carolina MEDICAID ZA9380

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