NPI | 1275808552 |
---|---|
Entity Type | Organization |
Authorized Contact | AVANGELA K CRISWELL Business Office Director 843-663-8017 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: SC 4406) |
Enumeration Date | 2012-03-20 |
Last Update Date | 2012-03-20 |