| NPI | 1063552206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET A ROTH Secretary Treasurer 864-235-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3616) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 3068) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |