| NPI | 1043462047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDWIN DEANE President 843-546-4416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 2634) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |