| NPI | 1053513598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BLAINE MILLER Doctor 803-327-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: SC 186) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-01-03 |