| NPI | 1083754865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST JASON GARDNER Owner Orthodontist 864-585-8709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC SC1930) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 332) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |