| NPI | 1255463808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN CROSBY LIVINGSTON President 803-781-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 2739) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |