Provider Demographics
NPI:1558595926
Name:DENTESTHET, LLC
Entity Type:Organization
Organization Name:DENTESTHET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:O
Authorized Official - Last Name:PORCELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-524-6363
Mailing Address - Street 1:1274 RIBAUT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-6187
Mailing Address - Country:US
Mailing Address - Phone:843-524-6363
Mailing Address - Fax:
Practice Address - Street 1:1274 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6187
Practice Address - Country:US
Practice Address - Phone:843-524-6363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC45301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty