| NPI | 1134598980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALAN BREAULT Dmd 843-884-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8323) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |