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General NPI Number Information
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NPI Number | 1174454243
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Entity Type | Individual
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Provider Name | GEOFFREY RACINE DMD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 101 HIGHWAY 17 S
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-3117
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Country | US
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Telephone | 843-888-2082
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Fax |
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Provider Business Mailing Address
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Address Line | 3912 HILDA ST
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-5547
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Country | US
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Telephone | 703-508-9732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DGD.11447.GD
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License Number State | SC
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