| NPI | 1013257724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WAYNE HOROWITZ Owner, Sole Member 843-397-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3112) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2013-02-18 |