| NPI | 1316216500 |
|---|---|
| Doing Business As | SURFSIDE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SCOTT J WILLIS Member 843-652-0011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1693) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |