Destination Dental LLC

NPI #1750919718 in Duncan, South Carolina

Provider Information

NPI Number: 1750919718
Entity Type: Organization
Organization Name: Destination Dental LLC
Primary Specialty: Dentist
Enumeration Date: Mar 27, 2020
Last Updated: Mar 27, 2020

Practice Location

Address: 155 DEACON TILLER CT STE 101
City: Duncan
State: South Carolina
ZIP Code: 29334-8880
Phone: (864) 485-2214

Authorized Official

Name: DR. BLAKE JULIAN, DDS
Title: PRACTICE OWNER
Phone: (864) 485-2214

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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