LONGBOARD DENTAL LLC; NPI #1134837503

Contact Information

LONGBOARD DENTAL LLC

405 FAISON ROAD
SUIRE A3
MOUNT PLEASANT, SC 29466

Phone: 843-654-1373
Fax: 843-654-1374
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for LONGBOARD DENTAL LLC

NPI #	`1134837503`
LBN Legal business name	LONGBOARD DENTAL LLC
Authorized official	ELLEN WOLF - (DENTIST)
Entity	Organization
Organization subpart ¹	No
Enumeration date	11/14/2022
Last updated	11/14/2022 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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