NPI | 1194710426 |
---|---|
Entity Type | Organization |
Authorized Contact | MARLON HUNTER CEO 864-582-2817 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2005-09-13 |
Last Update Date | 2020-05-18 |