Coastal Carolina Cosmetic Facial Surgery
NPI #1972081941 in Myrtle Beach, South Carolina
Provider Information
- NPI Number
- 1972081941
- Entity Type
- Organization
- Organization Name
- Coastal Carolina Cosmetic Facial Surgery
- Primary Specialty
- Clinic/Center - Oral and Maxillofacial Surgery
- Enumeration Date
- Aug 1, 2018
- Last Updated
- Dec 10, 2019
Practice Location
- Address
- 133 TOWNE CENTRE PKWY
- City
- Myrtle Beach
- State
- South Carolina
- ZIP Code
- 29579-3493
- Phone
- (843) 448-1621
Authorized Official
- Name
- MICHAEL JOHNSON, DDS
- Title
- MANAGING MEMBER
- Phone
- (720) 201-5801
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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