| NPI | 1134892722 | 
|---|---|
| Doing Business As | MOBILE DENTAL UNIT 2 | 
| Entity Type | Organization | 
| Authorized Contact | ARETHA R JONES CEO 843-722-4112  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Enumeration Date | 2021-07-29 | 
| Last Update Date | 2022-10-28 |