| NPI | 1013288786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD THOMAS MURPHY Member 843-571-0853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 3981) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: SC 1487) |
| 1223P0300X Dentist, Periodontics (Licence: SC 3204) | |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |