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1134837503
LONGBOARD DENTAL LLC
MT PLEASANT, SC
NPI
1134837503
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Entity Type
Organization
Authorized Contact
ELLEN PAULISICK WOLF
Dentist
843-654-1373
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center Dental
Enumeration Date
2022-11-14
Last Update Date
2022-11-14
Business Address
LONGBOARD DENTAL LLC
405 FAISON ROAD SUIRE A3
MT PLEASANT, SC 29466
Phone number: 843-654-1373
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Mailing Address
LONGBOARD DENTAL LLC
405 FAISON ROAD SUIRE A3
MT PLEASANT, SC 29466
Phone number: 843-654-1373
Copy
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