NPI | 1043409063 |
---|---|
Former Legal Business Name | CHARLESTON CENTER FOR ORAL & FACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | EDWARD R STRAUSS Owner 843-762-9028 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 4006) |
Enumeration Date | 2007-10-16 |
Last Update Date | 2012-10-19 |