Provider First Line Business Practice Location Address:
TIDELANDS DENTAL
Provider Second Line Business Practice Location Address:
1625 GLENNS BAY RD
Provider Business Practice Location Address City Name:
SURFSIDE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-650-4500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2009