| NPI | 1083722698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE HERSHON Orthodontist 843-553-2252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 1888) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |