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Jeffrey H Wallen D.d.s. P.c.
Oral and Maxillofacial Surgery (Dentist) in Myrtle Beach, South Carolina
NPI 1134242621

Jeffrey H Wallen D.d.s. P.c. is a Oral and Maxillofacial Surgery (Dentist) based in Myrtle Beach, SC and is specialized in Oral and Maxillofacial Surgery. Jeffrey H Wallen D.d.s. P.c. practices in Myrtle Beach, SC. The NPI Number for Jeffrey H Wallen D.d.s. P.c. is 1134242621 and holds a License No. 2959 (South Carolina).

The current practice location address for Jeffrey H Wallen D.d.s. P.c. is 1200 48Th Ave N Ste 101, Myrtle Beach, SC and can be reached out via phone at 843-449-4993 and via fax at 843-497-0647.

Location: 1200 48Th Ave N Ste 101, Myrtle Beach, SC, 29577-5423
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134242621
Provider Name
Jeffrey H Wallen D.d.s. P.c.
Credential
Provider Entity Type
Organization
Address
1200 48Th Ave N Ste 101, Myrtle Beach, SC, 29577-5423
Phone Number
843-449-4993
Fax Number
843-497-0647
Provider Enumeration Date
04/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8998844 01 NC NORTH CAROLINA MEDICIAD
ZA9905 05 SC
institution
Provider Business Practice Location Address Details
Address
1200 48Th Ave N Ste 101
City
Myrtle Beach
State
South Carolina
Zip
29577-5423
Phone Number
843-449-4993
Fax Number
843-497-0647
person
Provider Business Mailing Address Details
Address
1200 48Th Ave N Ste 101
City
Myrtle Beach
State
South Carolina
Zip
29577-5423
Phone Number
843-449-4993
Fax Number
843-497-0647
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
2959 (South Carolina)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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