Provider Demographics
NPI:1326493875
Name:PLEASANT SMILES COSMETIC & FAMILY DENTISTRY
Entity Type:Organization
Organization Name:PLEASANT SMILES COSMETIC & FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBENCHAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-884-0701
Mailing Address - Street 1:924 TALL PINE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2990
Mailing Address - Country:US
Mailing Address - Phone:843-884-0701
Mailing Address - Fax:
Practice Address - Street 1:924 TALL PINE RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2990
Practice Address - Country:US
Practice Address - Phone:843-884-0701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty