| NPI | 1174797526 |
|---|---|
| Other Name | PREMIER AESTHETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARK G. PELLETIER President/Dentist 803-781-7901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3232) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |