NPI | 1275006272 |
---|---|
Doing Business As | SUMMERVILLE PEDIATRIC ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | KATHRYN STROUD BULLWINKEL Owner 803-606-4988 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2019-01-02 |
Last Update Date | 2019-01-02 |