| NPI | 1205280351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARDS Partner 864-583-4962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 8255) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 2651) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |