| NPI | 1265561856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL CHRISTOPHER SHIRLEY Owner 843-815-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 3290) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-07-29 |