MEDICARE: SOUTH CAROLINA DENTAL TEAM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1851258123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH CAROLINA DENTAL TEAM PC

Provider Business Mailing Address
First Line	:	9709 LAKESIDE BLVD STE 350
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-1216
Country	:	US
Telephone Number	:	713-489-2198
Fax Number	:	713-489-2978

Provider Business Practice Location Address
First Line	:	3911 HIGHWAY 17 UNIT B
Second Line	:
City	:	MURRELLS INLET
State	:	SC
Zip	:	29576-5014
Country	:	US
Telephone Number	:	854-894-4525
Fax Number	:	843-473-8475

Authorized Official
Title or Position	:	OWNER
Name	:	ANN BYNUM
Credential	:	DDS
Telephone Number	:	713-489-2198

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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