OrganizationActive
Coastal Carolina Cosmetic Facial Surgery
NPI 1972081941 · Oral and Maxillofacial Surgery Clinic/Center · Myrtle Beach, SC
Provider details
- NPI number
- 1972081941
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Johnson, Managing Member(720) 201-5801
- License
- 8911 (SC)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
133 Towne Centre Pkwy
Myrtle Beach, SC 29579-3493
Phone: (843) 448-1621
Approximate (ZIP-level) locationGet directions
Mailing address
6210 N Ocean Blvd
Myrtle Beach, SC 29572-3300
Registry dates
- Enumerated
- 2018-08-01
- Last updated
- 2019-12-10
- Certified
- 2019-12-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.