Jordan Brown

Individual provider Active NPI General Practice Dentistry · Murrells Inlet, SC

NPI 1154856961 · NPPES record last updated Feb 13, 2024

Key facts

NPI
1154856961
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
9095 (SC)
Practice address
12307 Highway 707
Murrells Inlet, SC 29576-9740
Phone
(843) 651-6776
NPI assigned
Apr 29, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9095 SC Yes

Addresses

Primary practice location

12307 Highway 707
Murrells Inlet, SC 29576-9740

Mailing address

4908 Oat Fields Dr
Myrtle Beach, SC 29588-7968
Phone (801) 471-8220

Other providers in Murrells Inlet, SC

All providers in Murrells Inlet, SC · General Practice Dentistry in South Carolina

Sources for this page

Verify at the official NPI Registry.