| NPI | 1043561087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN F MEEKS Owner 843-784-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 2940) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 3665) |
| 122300000X Dentist (Licence: SC 8128) | |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |