NPI 1386891463

Edisto Dental Associates of Sc, LLC

Organisation Exclusive Provider Organization Edisto Island, SC

Practice location

Address: 51 Station CT STE C, Edisto Island, SC 29438-3020
Phone: (843) 869-3368
Mailing address: PO Box 218, Edisto Island, SC 29438-0218

Authorised official

Name: Julie Corley
Title: Office Manager
Phone: (803) 279-0015

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 2109 (SC)

Other Exclusive Provider Organization providers in South Carolina →

Registry record

NPI: 1386891463
Entity type: Organization
NPI issued: 20 Aug 2008
Record last updated: 20 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.