| NPI | 1053826057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMERSON F GOWER Owner/Dentist 803-943-4895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: SC 7047) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |