Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coastal Carolina Oral Maxillofacial Surgery

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1194812339

Coastal Carolina Oral Maxillofacial Surgery is an Oral and Maxillofacial Surgery (Dentist) in Myrtle Beach, South Carolina. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

133 Towne Centre Pkwy
Myrtle Beach, SC 29579
Phone: (843) 448-1621
Fax: (843) 626-2501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X
Oral and Maxillofacial Surgery Clinic/Center Taxonomy 261QS0112X

Record details

NPI number1194812339
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wilma Pond — Practice Administrator · (843) 448-1621
NPI enumeratedOctober 9, 2006
Last updated in NPPESApril 11, 2024
Certification dateApril 11, 2024
Mailing address133 Towne Centre Pkwy, Myrtle Beach, SC 29579

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