| NPI | 1851115810 |
|---|---|
| Doing Business As | SURFSIDE SMILES |
| Entity Type | Organization |
| Authorized Contact | SCOTT JOHN WILLIS Owner 843-450-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |