| NPI | 1134245145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA KLATT DEPAUL Owner 843-345-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 02529) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2013-08-08 |