| NPI | 1235312356 |
|---|---|
| Doing Business As | MODERN FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | STEPHEN C CHADWICK Owner/Dentist 843-744-6971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3252) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 3436) |
| 122300000X Dentist (Licence: SC 1206) | |
| 122300000X Dentist (Licence: SC 963) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |