| NPI | 1275793648 |
|---|---|
| Doing Business As | NORTHEAST DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JOHN C COSBY President Owner 803-754-9160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC SC1677) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |