| NPI | 1205041530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FRONTIS WATSON Dentist 864-233-0075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1905) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |