| NPI | 1093848368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH MARTIN BURTNER Oral Surgeon 803-548-9910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 3553611) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |