| NPI | 1174998892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL PURNELL President 803-785-4460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 8336) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2017-01-31 |