Provider Demographics
NPI:1770099384
Name:KIDZ PLANET PEDIATRIC DENTISTRY HHI, PA
Entity type:Organization
Organization Name:KIDZ PLANET PEDIATRIC DENTISTRY HHI, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWASTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:843-871-8700
Mailing Address - Street 1:102 MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-9010
Mailing Address - Country:US
Mailing Address - Phone:843-871-8700
Mailing Address - Fax:
Practice Address - Street 1:21 MATHEWS DR STE 1
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-3757
Practice Address - Country:US
Practice Address - Phone:843-681-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty