Provider Demographics
NPI:1639331192
Name:SOUTH CAROLINA DENTAL SCREENING ASSOCIATES LLP
Entity Type:Organization
Organization Name:SOUTH CAROLINA DENTAL SCREENING ASSOCIATES LLP
Other - Org Name:CLASSY SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HELERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPA
Authorized Official - Phone:516-318-2839
Mailing Address - Street 1:64 EGRET RUN LN
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-7821
Mailing Address - Country:US
Mailing Address - Phone:516-318-2839
Mailing Address - Fax:843-278-8014
Practice Address - Street 1:64 EGRET RUN LN
Practice Address - Street 2:SUITE B-1
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7821
Practice Address - Country:US
Practice Address - Phone:516-318-2839
Practice Address - Fax:843-278-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty