Healthcare Provider Details

I. General information

NPI: 1326952359
Provider Name (Legal Business Name): EAST COAST DENTAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4036 RIVER OAKS DR STE B2
MYRTLE BEACH SC
29579-6695
US

IV. Provider business mailing address

4036 RIVER OAKS DR STE B2
MYRTLE BEACH SC
29579-6695
US

V. Phone/Fax

Practice location:
  • Phone: 304-376-2603
  • Fax:
Mailing address:
  • Phone: 304-376-2603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MATTHEW MILLER
Title or Position: CEO
Credential: DDS
Phone: 304-376-2603