| NPI | 1104363233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TYLER WILLIAMS Owner 843-819-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 6968) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |