Provider Demographics
NPI:1407576465
Name:RIVER LANDING DENTISTRY WEST SUMMERVILLE LLC
Entity Type:Organization
Organization Name:RIVER LANDING DENTISTRY WEST SUMMERVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ITS MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZECHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-242-0645
Mailing Address - Street 1:145 RIVER LANDING DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8612
Mailing Address - Country:US
Mailing Address - Phone:843-242-0645
Mailing Address - Fax:
Practice Address - Street 1:2636 HIGHWAY 17A S STE A
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-9114
Practice Address - Country:US
Practice Address - Phone:843-242-0645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty