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General NPI Number Information
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NPI Number | 1770099384
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Entity Type | Organization
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Legal Business Name | KIDZ PLANET PEDIATRIC DENTISTRY HHI, PA
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 21 MATHEWS DR STE 1
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City | HILTON HEAD
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State | SC
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Zip | 29926-3757
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Country | US
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Telephone | 843-681-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 102 MURRAY BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29483-9010
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Country | US
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Telephone | 843-871-8700
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. DENISE SWASTY
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Credential | DDS, MS
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Telephone | 843-871-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 4439
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License Number State | SC
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