| NPI | 1104048289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KASSIS LONG President 843-556-7444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3790) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |