| NPI | 1154665776 |
|---|---|
| Doing Business As | IMMEDIATE DENTAL GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | ZACHARY TODD DAUGHERTY Business Manager 843-480-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2013-01-22 |