LAKE MOULTRIE DENTAL LLC

MONCKS CORNER, SC
NPI1013482603
Entity TypeOrganization
Authorized ContactBRIAN LEWIS JAQUES
Owner/Dentist
843-761-8720
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2018-10-10
Last Update Date2018-10-10
Business Address
LAKE MOULTRIE DENTAL LLC
205 CAROLINA AVE
MONCKS CORNER, SC 29461-3736
Phone number: 843-761-8720
Mailing Address
LAKE MOULTRIE DENTAL LLC
205 CAROLINA AVE
MONCKS CORNER, SC 29461-3736
Phone number: 843-761-8720
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