| NPI | 1255059283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK EDWARD HOUSTON CEO 864-439-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |