Provider Demographics
NPI:1760700157
Name:ST. JAMES DENTISTRY, LLC
Entity Type:Organization
Organization Name:ST. JAMES DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-650-2000
Mailing Address - Street 1:9403 HIGHWAY 707
Mailing Address - Street 2:SUITE D
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-7758
Mailing Address - Country:US
Mailing Address - Phone:843-650-2000
Mailing Address - Fax:843-650-2007
Practice Address - Street 1:9403 HIGHWAY 707
Practice Address - Street 2:SUITE D
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7758
Practice Address - Country:US
Practice Address - Phone:843-650-2000
Practice Address - Fax:843-650-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4356122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty