| NPI | 1063425247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W NIMMICH Owner 803-905-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: SC SC2676SCSPECIALTY507) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-08-05 |