Provider Demographics
NPI:1013524602
Name:MERRITT FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:MERRITT FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:MORRELL
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-352-9916
Mailing Address - Street 1:1441 N POINT LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4624
Mailing Address - Country:US
Mailing Address - Phone:843-352-9916
Mailing Address - Fax:843-388-7649
Practice Address - Street 1:1441 N POINT LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4624
Practice Address - Country:US
Practice Address - Phone:843-352-9916
Practice Address - Fax:843-388-7649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental