Provider Demographics
NPI:1174720312
Name:MURRELLS INLET DENTISTRY
Entity type:Organization
Organization Name:MURRELLS INLET DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-651-5557
Mailing Address - Street 1:4405 HIGHWAY 17 BY PASS S.
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-651-5557
Mailing Address - Fax:843-651-6571
Practice Address - Street 1:4405 HIGHWAY 17 BY PASS S.
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-651-5557
Practice Address - Fax:843-651-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty