| NPI | 1295805042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER D STOLTZ Dentist President 803-755-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 2688) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |