| NPI | 1093075939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP NOEL RENDER Dentist, Dean Of Academic Affairs 843-477-2171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |