| NPI | 1083615330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD R. MOORE Dentist 864-882-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1600) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2007-08-28 |