| NPI | 1295851236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE DENNIS SPACEY President 843-559-3135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC SC2958) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |