Legacy Prosthodontics LLC
NPI #1154208510 in Myrtle Beach, South Carolina
Provider Information
- NPI Number
- 1154208510
- Entity Type
- Organization
- Organization Name
- Legacy Prosthodontics LLC
- Primary Specialty
- Dentist - Prosthodontics
- Enumeration Date
- Aug 18, 2025
- Last Updated
- Aug 18, 2025
Practice Location
- Address
- 3017 NEWCASTLE LOOP
- City
- Myrtle Beach
- State
- South Carolina
- ZIP Code
- 29588-4502
- Phone
- (843) 215-4343
Authorized Official
- Name
- DR. CHARLES JOHNSON, DMD
- Title
- OWNER-DENTIST
- Phone
- (843) 215-4343
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Prosthodontics — Prosthodontics |
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