| NPI | 1164952842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW BRIAN BULLARD President 864-907-4684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 3674) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |