| NPI | 1306929344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN JOEL VOELKERT Partner 864-271-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 2029) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: SC 2496) |
| 1223P0300X Dentist, Periodontics (Licence: SC 3832) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |