| NPI | 1316084197 |
|---|---|
| Doing Business As | PALMETTO PERIODONTICS PA |
| Entity Type | Organization |
| Authorized Contact | LISA S RAVENEL Owner 864-987-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 3710) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |