| NPI | 1265743785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY GRANT HOLLIDAY Member 864-885-1579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 4621) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |