| NPI | 1114287042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVI SAGUNARTHY Owner/President 803-547-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 4692) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4692) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |