Provider Demographics
NPI:1720277650
Name:HILTON HEAD DENTAL TEAM, LLC
Entity Type:Organization
Organization Name:HILTON HEAD DENTAL TEAM, LLC
Other - Org Name:HILTON HEAD DENTAL TEAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAMP-TOME
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-681-9666
Mailing Address - Street 1:92 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1684
Mailing Address - Country:US
Mailing Address - Phone:843-681-9666
Mailing Address - Fax:843-681-8293
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1684
Practice Address - Country:US
Practice Address - Phone:843-681-9666
Practice Address - Fax:843-681-8293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty