| NPI | 1295793289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA LUCAS Regional Director Of Operations 864-523-5771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2025-03-25 |