Healthcare Provider Details

I. General information

NPI: 1356155808
Provider Name (Legal Business Name): AARON SPENCER TOLER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 GLENNS BAY RD
MYRTLE BEACH SC
29575-4836
US

IV. Provider business mailing address

1625 GLENNS BAY RD
MYRTLE BEACH SC
29575-4836
US

V. Phone/Fax

Practice location:
  • Phone: 843-650-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDGD.11312.GD
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: