| NPI | 1104974609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR LEBEDOVYCH President 864-967-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 4084) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |