| NPI | 1144355108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY S. FREEMAN Office Manager 864-246-8347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4054) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |