Coastal Kids Dental & Braces
Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Walterboro, SC
NPI 1376932798 · NPPES record last updated Jan 22, 2015
Key facts
- NPI
- 1376932798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 4476 (SC)
- Legal business name
- COASTAL KIDS DENTAL & BRACES
- Practice address
- 118 S Walter St
Walterboro, SC 29488-3956 - Phone
- (843) 818-5437
- Fax
- (843) 725-1594
- NPI assigned
- Jan 22, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- COASTAL KIDS DENTAL, PA
Authorized official
- Name
- Jacob Driggers
- Title
- Coo
- Phone
- (843) 818-5437
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Coastal Kids Dental Braces
- Part of
- Coastal Kids Dental
Locations
808 Wappoo Rd
Charleston, SC 29407
Phone (262) 565-8298
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | 4476 | SC | Yes |
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | 4209 | SC |
Addresses
Primary practice location
118 S Walter St
Walterboro, SC 29488-3956
Mailing address
808 Wappoo Rd
Charleston, SC 29407-5865
Phone (843) 818-5437
Other providers in Walterboro, SC
- Charleston Brace Company, LLC
- Charleston Cancer Center
- Charleston Family Center, LLC in Walterboro
- Linda Chipukites
- Coastal Ambulance LLC
- Coastal Kids Dental,PA
- Coastal Life Ambulance, Inc.
- Coastal Medical Services LLC
- Cole L Lawson III, Inc
- Colleton Ambulatory Care, LLC
All providers in Walterboro, SC · Orthodontics and Dentofacial Orthopedics Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.