| NPI | 1295961274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBET MICHAEL JOHNSON Dentist 803-252-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC SC-2275) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: SC SC-4484) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2009-06-04 |