| NPI | 1285338210 |
|---|---|
| Doing Business As | FAMILY DENTAL HEALTH OF CHARLESTON SOUTHERN LLC |
| Entity Type | Organization |
| Authorized Contact | BETH ILLSLEY Director Of Insurance 864-282-1935 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-05-01 |