| NPI | 1053887653 |
|---|---|
| Doing Business As | BROAD RIVER DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TONIA PATTERSON Practice Administrator 803-600-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |