| NPI | 1043630437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DEREK AYERS President 843-406-3678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 6942) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |