| NPI | 1164304986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENNELL SMITH Dentist 803-626-1265 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |