Heritage Dental LLC
NPI #1467982728 in Ladson, South Carolina
Provider Information
- NPI Number
- 1467982728
- Entity Type
- Organization
- Organization Name
- Heritage Dental LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jun 19, 2017
- Last Updated
- Jun 20, 2018
Practice Location
- Address
- 9598 PALMETTO COMMERCE PARKWAY
- City
- Ladson
- State
- South Carolina
- ZIP Code
- 29456
- Phone
- (860) 573-5681
Authorized Official
- Name
- DR. ROBERT ALAN BREAULT, DMD
- Title
- PRESIDENT
- Phone
- (860) 573-5681
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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