| NPI | 1134472699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HOLLAND Office Staff 864-622-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 03245) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2012-10-22 |